Healthcare Provider Details

I. General information

NPI: 1558134924
Provider Name (Legal Business Name): RAVEN TURNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 E BOGARD RD
WASILLA AK
99654-4711
US

IV. Provider business mailing address

7010 E BOGARD RD
WASILLA AK
99654-4711
US

V. Phone/Fax

Practice location:
  • Phone: 678-517-3666
  • Fax:
Mailing address:
  • Phone: 678-517-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018420
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: