Healthcare Provider Details

I. General information

NPI: 1194645317
Provider Name (Legal Business Name): MIKAYLA TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 COLORADO AVE
PUEBLO CO
81004-2005
US

IV. Provider business mailing address

327 COLORADO AVE
PUEBLO CO
81004-2005
US

V. Phone/Fax

Practice location:
  • Phone: 719-948-7120
  • Fax:
Mailing address:
  • Phone: 719-948-7120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022334
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: