Healthcare Provider Details

I. General information

NPI: 1205553013
Provider Name (Legal Business Name): TURNER THERAPY AND WELLNESS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 09/23/2023
Certification Date: 09/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 COLLEGE AVE STE B
JACKSON KY
41339-1070
US

IV. Provider business mailing address

3610 HIGHWAY 1933
JACKSON KY
41339-8560
US

V. Phone/Fax

Practice location:
  • Phone: 606-233-3414
  • Fax:
Mailing address:
  • Phone: 606-568-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUSAN CAROL TURNER
Title or Position: PRIVATE PRACTICE OWNER/OPERATOR
Credential: LPCC
Phone: 606-221-7272