Provider Demographics
NPI:1417252859
Name:TURNER, LAVAUGHN MAURICE JR (LICSW, LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:LAVAUGHN
Middle Name:MAURICE
Last Name:TURNER
Suffix:JR
Gender:M
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 EMERSON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6113
Mailing Address - Country:US
Mailing Address - Phone:202-545-8489
Mailing Address - Fax:
Practice Address - Street 1:414 EMERSON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6113
Practice Address - Country:US
Practice Address - Phone:202-545-8489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-16
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500786531041C0700X
MD159681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical