Healthcare Provider Details

I. General information

NPI: 1861293102
Provider Name (Legal Business Name): MARLON D TURNER CSAC-A; RPRS; CPRS-T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 WILLOW LAWN DR STE 304
RICHMOND VA
23230-3423
US

IV. Provider business mailing address

1601 WILLOW LAWN DR STE 304 #1409
RICHMOND VA
23230-3423
US

V. Phone/Fax

Practice location:
  • Phone: 804-634-7386
  • Fax:
Mailing address:
  • Phone: 804-634-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0711000695
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number0735001034
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: