MEDICARE: STACIA TURNER LGCP

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
1	101YM0800X	Mental Health Counselor	LGCP200001842	DC
2	374J00000X	Doula

General Provider Information

NPI Number	:	1598461642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIA TURNER LGCP

Provider Business Mailing Address
First Line	:	11805 CHARLES RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-4721
Country	:	US
Telephone Number	:	480-390-2152
Fax Number	:

Provider Business Practice Location Address
First Line	:	11805 CHARLES RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-4721
Country	:	US
Telephone Number	:	480-390-2152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	12/16/2024

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