Provider Demographics
NPI:1982925798
Name:TURNER, SANDRA MECHELLE (LCSW; LISW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MECHELLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:LCSW; LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1803
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-1803
Mailing Address - Country:US
Mailing Address - Phone:575-218-4885
Mailing Address - Fax:505-888-1683
Practice Address - Street 1:2050A 2ND ST SE
Practice Address - Street 2:
Practice Address - City:KIRKLAND AFB
Practice Address - State:NM
Practice Address - Zip Code:87117-5901
Practice Address - Country:US
Practice Address - Phone:505-846-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-078291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM91478341Medicaid