Provider Demographics
NPI:1346413689
Name:TURNAGE, CONNIE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:M
Last Name:TURNAGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 BURTFIELD CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2830
Mailing Address - Country:US
Mailing Address - Phone:804-399-8977
Mailing Address - Fax:804-652-2899
Practice Address - Street 1:4708 BURTFIELD CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2830
Practice Address - Country:US
Practice Address - Phone:804-304-5838
Practice Address - Fax:804-368-1424
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040020321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010077729Medicaid