Provider Demographics
NPI:1376063602
Name:TURNER, KRISTY LYNN (LSW)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LYNN
Last Name:TURNER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:KRISTY
Other - Middle Name:LYNN
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23681 ASHTON CT
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-8792
Mailing Address - Country:US
Mailing Address - Phone:419-602-3655
Mailing Address - Fax:
Practice Address - Street 1:311 W HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-2827
Practice Address - Country:US
Practice Address - Phone:419-602-3655
Practice Address - Fax:419-602-3655
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33005837A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker