Provider Demographics
NPI:1497350045
Name:TURNER, LANCE (LCDCII)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:LCDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 OSTEND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1520
Mailing Address - Country:US
Mailing Address - Phone:937-260-8250
Mailing Address - Fax:
Practice Address - Street 1:600 WALNUT ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1944
Practice Address - Country:US
Practice Address - Phone:937-548-6842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCII.161948101YA0400X
OHCDCA.177324101YA0400X
OHCDCA.174448101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)