Healthcare Provider Details

I. General information

NPI: 1063829182
Provider Name (Legal Business Name): NICOLE L TURNER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE L MCMANUS LMFT

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4711 44TH AVE SW STE C
SEATTLE WA
98116-4401
US

IV. Provider business mailing address

4711 44TH AVE SW STE C
SEATTLE WA
98116-4401
US

V. Phone/Fax

Practice location:
  • Phone: 910-258-0895
  • Fax:
Mailing address:
  • Phone: 910-258-0895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1975
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number60504223
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF.2500545
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: