Provider Demographics
NPI:1407157563
Name:TURNER, SUSAN CAROL (MED, LPCC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CAROL
Last Name:TURNER
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 HIGHWAY 1933
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-8560
Mailing Address - Country:US
Mailing Address - Phone:606-221-7272
Mailing Address - Fax:
Practice Address - Street 1:1029 COLLEGE AVE STE 101B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-1073
Practice Address - Country:US
Practice Address - Phone:606-221-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
KY50179226376K00000X, 376K00000X
KY251190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100874760Medicaid
KY273982OtherKENTUCKY BOARD OF LICENSURE