Provider Demographics
NPI:1720389562
Name:TURNER, MONIKA B (LCMHC)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:B
Last Name:TURNER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4185 ST GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7695
Mailing Address - Country:US
Mailing Address - Phone:802-651-7739
Mailing Address - Fax:
Practice Address - Street 1:4185 ST GEORGE RD
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7695
Practice Address - Country:US
Practice Address - Phone:802-651-7739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101YA0400X, 101YM0800X
VT068.0073116101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT104277OtherASAC