Healthcare Provider Details

I. General information

NPI: 1265955538
Provider Name (Legal Business Name): SHANTI MARIE TURNER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 CHAMBERLAIN ST
PONTIAC MI
48342-1475
US

IV. Provider business mailing address

121 CHAMBERLAIN ST
PONTIAC MI
48342-1475
US

V. Phone/Fax

Practice location:
  • Phone: 248-678-2989
  • Fax: 248-458-4114
Mailing address:
  • Phone: 248-678-2989
  • Fax: 248-458-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851105747
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: