Provider Demographics
NPI:1396729950
Name:TURNER, IRENE LORRAINE (MA,LPC-S)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:LORRAINE
Last Name:TURNER
Suffix:
Gender:F
Credentials:MA,LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E AIRLINE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3908
Mailing Address - Country:US
Mailing Address - Phone:361-575-5151
Mailing Address - Fax:361-575-5153
Practice Address - Street 1:303 E AIRLINE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3908
Practice Address - Country:US
Practice Address - Phone:361-575-5151
Practice Address - Fax:361-575-5153
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095960302Medicaid