Provider Demographics
NPI:1679214704
Name:TURNER, JENNIFER (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6431
Mailing Address - Country:US
Mailing Address - Phone:910-202-3155
Mailing Address - Fax:910-202-5772
Practice Address - Street 1:309 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425-3280
Practice Address - Country:US
Practice Address - Phone:910-259-0668
Practice Address - Fax:910-202-9966
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0174091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1922022607Medicaid