Provider Demographics
NPI:1790349173
Name:TURNER, JUSTIN DEVON (LMSW)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:DEVON
Last Name:TURNER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9741 EUSTICE RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2511
Mailing Address - Country:US
Mailing Address - Phone:410-698-2298
Mailing Address - Fax:
Practice Address - Street 1:3100 LORD BALTIMORE DR STE 208
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2882
Practice Address - Country:US
Practice Address - Phone:410-701-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23989104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker