Provider Demographics
NPI:1568084622
Name:TURK, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:TURK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:TURK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:112 W JEFFERSON AVE STE 122
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4062
Mailing Address - Country:US
Mailing Address - Phone:314-852-8543
Mailing Address - Fax:
Practice Address - Street 1:112 W JEFFERSON AVE STE 122
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-4062
Practice Address - Country:US
Practice Address - Phone:314-852-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018045604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health