Provider Demographics
NPI:1437551454
Name:TURNIPSEED, BRIAN WADE (MS, MFT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:WADE
Last Name:TURNIPSEED
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LAKE FRONT DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-2206
Mailing Address - Country:US
Mailing Address - Phone:479-968-7092
Mailing Address - Fax:
Practice Address - Street 1:404 LAKE FRONT DRIVE
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802
Practice Address - Country:US
Practice Address - Phone:479-968-7086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
ARM2106026106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist