MEDICARE: KATHI A. TURNER L.C.S.W.

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	101YM0800X	Mental Health Counselor	LCS 15418	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LCS 15418	OTHER	CA	LCSW

General Provider Information

NPI Number	:	1699870980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHI A. TURNER L.C.S.W.

Provider Business Mailing Address
First Line	:	13612 DEBBY ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-2420
Country	:	US
Telephone Number	:	818-988-8942
Fax Number	:	818-988-8941

Provider Business Practice Location Address
First Line	:	584 N LARCHMONT BLVD
Second Line	:	SECOND FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-1306
Country	:	US
Telephone Number	:	818-988-8942
Fax Number	:	818-988-8941

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/08/2007

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