Provider Demographics
NPI:1407987035
Name:TURNER-SHARPTON, MARIAN L (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:L
Last Name:TURNER-SHARPTON
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 1:5079 CYPRESS LINKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:FL
Mailing Address - Zip Code:32033-2032
Mailing Address - Country:US
Mailing Address - Phone:904-731-4114
Mailing Address - Fax:904-737-9369
Practice Address - Street 1:2200 N PONCE DE LEON BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-2650
Practice Address - Country:US
Practice Address - Phone:904-731-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 00014491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ4845OtherBLUE CROSS BLUE SHIELD
FLP00057131OtherMEDICARE RAILROAD
R03753Medicare UPIN
FLZ4845Medicare ID - Type Unspecified