Provider Demographics
NPI:1649053448
Name:TURNER, CEDRIC K
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:K
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 RUSSIAN OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7643
Mailing Address - Country:US
Mailing Address - Phone:720-447-5216
Mailing Address - Fax:
Practice Address - Street 1:3624 RUSSIAN OLIVE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7643
Practice Address - Country:US
Practice Address - Phone:720-447-5216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty