Healthcare Provider Details

I. General information

NPI: 1013159375
Provider Name (Legal Business Name): TINA M TURNER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 4TH AVE
HUNTINGTON WV
25701-1219
US

IV. Provider business mailing address

PO BOX 9514
HUNTINGTON WV
25704-0514
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-7553
  • Fax: 304-522-7838
Mailing address:
  • Phone: 304-690-6784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2008-2524
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: