Provider Demographics
NPI:1487038626
Name:TURNING LEAF THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:TURNING LEAF THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS-C
Authorized Official - Phone:301-613-7709
Mailing Address - Street 1:4909 WATERS EDGE DR STE 200D
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2462
Mailing Address - Country:US
Mailing Address - Phone:301-613-7709
Mailing Address - Fax:919-598-5342
Practice Address - Street 1:4909 WATERS EDGE DRIVE 200D
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606
Practice Address - Country:US
Practice Address - Phone:301-613-7709
Practice Address - Fax:919-598-5342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0085551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1912157983Medicaid