Healthcare Provider Details

I. General information

NPI: 1730747510
Provider Name (Legal Business Name): RAY EMERSON TURNER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 S NEIL ST
CHAMPAIGN IL
61820-7266
US

IV. Provider business mailing address

2125 S NEIL ST
CHAMPAIGN IL
61820-7266
US

V. Phone/Fax

Practice location:
  • Phone: 217-352-0200
  • Fax: 217-607-1139
Mailing address:
  • Phone: 217-352-0200
  • Fax: 217-607-1139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number178.014871
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.014871
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: