Healthcare Provider Details

I. General information

NPI: 1013233980
Provider Name (Legal Business Name): MICHAEL R TURLEY MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 SOUTHLAND AVE
KOKOMO IN
46902-3637
US

IV. Provider business mailing address

979 ECHO LN
KOKOMO IN
46902-2602
US

V. Phone/Fax

Practice location:
  • Phone: 765-290-3789
  • Fax: 765-450-6787
Mailing address:
  • Phone: 765-437-0313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: