Provider Demographics
NPI:1518296268
Name:TURNER, PEGGY S (LCPC,LADC)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:S
Last Name:TURNER
Suffix:
Gender:F
Credentials:LCPC,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 PARK ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARIS
Mailing Address - State:ME
Mailing Address - Zip Code:04281-6438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:659 PARK ST
Practice Address - Street 2:
Practice Address - City:SOUTH PARIS
Practice Address - State:ME
Practice Address - Zip Code:04281-6438
Practice Address - Country:US
Practice Address - Phone:207-357-7072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC2611101YA0400X
MECC2503101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431652199Medicaid