Provider Demographics
NPI:1205325735
Name:TURRIAGO, LUIS CARLOS (PHD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:CARLOS
Last Name:TURRIAGO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2626
Mailing Address - Country:US
Mailing Address - Phone:413-256-0494
Mailing Address - Fax:
Practice Address - Street 1:15 WILLOW LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2626
Practice Address - Country:US
Practice Address - Phone:413-256-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9018103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9018OtherDIVISION OF PROFESSIONAL LICENSURE