Healthcare Provider Details

I. General information

NPI: 1568424307
Provider Name (Legal Business Name): SHAWN TURLEY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 N 51ST AVE
PHOENIX AZ
85031-1721
US

IV. Provider business mailing address

2702 N 3RD ST
PHOENIX AZ
85004-4608
US

V. Phone/Fax

Practice location:
  • Phone: 623-247-6266
  • Fax: 623-247-9742
Mailing address:
  • Phone: 602-323-3407
  • Fax: 602-323-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-10976
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: