Healthcare Provider Details

I. General information

NPI: 1407987035
Provider Name (Legal Business Name): MARIAN L TURNER-SHARPTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 N PONCE DE LEON BLVD STE 3
ST AUGUSTINE FL
32084-2650
US

IV. Provider business mailing address

5079 CYPRESS LINKS BLVD
ELKTON FL
32033-2032
US

V. Phone/Fax

Practice location:
  • Phone: 904-731-4114
  • Fax:
Mailing address:
  • Phone: 904-731-4114
  • Fax: 904-737-9369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 0001449
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: