Provider Demographics
NPI:1689220709
Name:TURNBOUGH, MICHELLE (LCPC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:TURNBOUGH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15523B KEATING AVE
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-3638
Mailing Address - Country:US
Mailing Address - Phone:773-467-6739
Mailing Address - Fax:
Practice Address - Street 1:15523B KEATING AVE
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-3638
Practice Address - Country:US
Practice Address - Phone:773-467-6739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011409101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional