Healthcare Provider Details

I. General information

NPI: 1578569521
Provider Name (Legal Business Name): MARISA SENSABAUGH TURPIN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARISA DAWN SENSABAUGH L.C.S.W.

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E WASHINGTON ST
LEXINGTON VA
24450-2718
US

IV. Provider business mailing address

204 E WASHINGTON ST
LEXINGTON VA
24450-2718
US

V. Phone/Fax

Practice location:
  • Phone: 540-462-7384
  • Fax:
Mailing address:
  • Phone: 540-462-7384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904002702
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: