=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912083593
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOUGLAS L TURNER LSCSW PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 225 SOUTHWIND PLACE
-----------------------------------------------------
City | MANHATTAN
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-776-5858
-----------------------------------------------------
Fax | 785-776-6152
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 225 SOUTHWIND PLACE
-----------------------------------------------------
City | MANHATTAN
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-776-5858
-----------------------------------------------------
Fax | 785-776-6152
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DOUGLAS L TURNER
-----------------------------------------------------
Credential | LSCSW
-----------------------------------------------------
Telephone | 785-776-5858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 2211
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------