Provider Demographics
NPI:1528013612
Name:TURRENTINE, LUANNE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUANNE
Middle Name:A
Last Name:TURRENTINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 MARSHALL CROWN RD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-6432
Mailing Address - Country:US
Mailing Address - Phone:703-968-4149
Mailing Address - Fax:
Practice Address - Street 1:5013 MARSHALL CROWN RD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-6432
Practice Address - Country:US
Practice Address - Phone:703-968-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003096103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG954-0001OtherCAREFIRST BLUECROSS BLUES
VA2171277OtherCIGNA
VA101889OtherANTHEM BLUECROSS BLUESHIE
VA380617OtherTRICARE
VA560471000OtherMAGELLAN
VA101889OtherANTHEM BLUECROSS BLUESHIE