Provider Demographics
NPI:1811922651
Name:TURNER, JOHN PENN (LPC, LSATP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PENN
Last Name:TURNER
Suffix:
Gender:M
Credentials:LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CATY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-3208
Mailing Address - Country:US
Mailing Address - Phone:434-978-3900
Mailing Address - Fax:434-978-3933
Practice Address - Street 1:106 CATY LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3208
Practice Address - Country:US
Practice Address - Phone:434-978-3900
Practice Address - Fax:434-978-3933
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA718000055101YA0400X
VA701002755101YP2500X
NC5588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010052661Medicaid