MEDICARE: CRISTINA TURNER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SL06322600	NJ
2	104100000X	Social Worker	44SC05915800	NJ
3	1041C0700X	Clinical Social Worker	11818	CT

General Provider Information

NPI Number	:	1679076574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA TURNER LCSW

Provider Business Mailing Address
First Line	:	80 FISHER DR
Second Line	:
City	:	AVON
State	:	CT
Zip	:	06001-3798
Country	:	US
Telephone Number	:	860-674-0088
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 FISHER DR
Second Line	:
City	:	AVON
State	:	CT
Zip	:	06001-3798
Country	:	US
Telephone Number	:	860-674-0088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2018
Last Update Date	:	11/03/2022

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