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NPI Code Detail

MEDICARE: DOUGLAS TURK LICSW

MEDICARE: DOUGLAS TURK LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker068669-1NY
21041C0700XClinical Social Worker22228MN

General Provider Information

NPI Number : 1336171016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS TURK LICSW
Provider Business Mailing Address
First Line : 2525 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-4518
Country : US
Telephone Number : 612-813-6029
Fax Number :
Provider Business Practice Location Address
First Line : 1100 GLENWOOD AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55405-1430
Country : US
Telephone Number : 612-871-1454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 01/31/2024

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Directions to “ DOUGLAS TURK LICSW” Practice Location

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