Provider Demographics
NPI:1831712900
Name:TURNER, TERRY (LPC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4132 WOODLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-8554
Mailing Address - Country:US
Mailing Address - Phone:618-239-4700
Mailing Address - Fax:
Practice Address - Street 1:4132 WOODLAND PARK DR
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-8554
Practice Address - Country:US
Practice Address - Phone:618-477-4452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-24
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178014117101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional