Healthcare Provider Details

I. General information

NPI: 1003720806
Provider Name (Legal Business Name): TURNER TALIAFERRO SMITH III PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 COX RD STE 205
GLEN ALLEN VA
23060-6803
US

IV. Provider business mailing address

105 CHARNWOOD RD
HENRICO VA
23229-7903
US

V. Phone/Fax

Practice location:
  • Phone: 804-796-0790
  • Fax:
Mailing address:
  • Phone: 404-263-8409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009554
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: