Healthcare Provider Details

I. General information

NPI: 1295188092
Provider Name (Legal Business Name): JANUARY L TURNER MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 RIBERIA ST SUITE 150
SAINT AUGUSTINE FL
32084-3300
US

IV. Provider business mailing address

4071 NEW HAMPSHIRE RD
ELKTON FL
32033-2124
US

V. Phone/Fax

Practice location:
  • Phone: 904-501-7578
  • Fax:
Mailing address:
  • Phone: 904-501-7578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14185
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: