Healthcare Provider Details

I. General information

NPI: 1982925798
Provider Name (Legal Business Name): SANDRA MECHELLE TURNER LCSW; LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 JUAN TABO BLVD NE STE 121E
ALBUQUERQUE NM
87112-1885
US

IV. Provider business mailing address

PO BOX 1803
TIJERAS NM
87059-1803
US

V. Phone/Fax

Practice location:
  • Phone: 575-218-4885
  • Fax:
Mailing address:
  • Phone: 575-218-4885
  • Fax: 505-888-1683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-07829
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: