Provider Demographics
NPI:1578569521
Name:TURPIN, MARISA SENSABAUGH (LCSW)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:SENSABAUGH
Last Name:TURPIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:DAWN
Other - Last Name:SENSABAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:204 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2718
Mailing Address - Country:US
Mailing Address - Phone:540-462-7384
Mailing Address - Fax:
Practice Address - Street 1:204 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2718
Practice Address - Country:US
Practice Address - Phone:540-462-7384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040027021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945271Medicaid
007373R71Medicare PIN
VA004945271Medicaid