MEDICARE: MR. LAVAUGHN MAURICE TURNER LCSW-C

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	11017	MD
2	171M00000X	Case Manager/Care Coordinator	0029858 00	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720258759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAVAUGHN MAURICE TURNER LCSW-C

Provider Business Mailing Address
First Line	:	1300 MERCANTILE LN STE 208
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5340
Country	:	US
Telephone Number	:	301-583-0001
Fax Number	:	301-583-3403

Provider Business Practice Location Address
First Line	:	1300 MERCANTILE LN STE 208
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5340
Country	:	US
Telephone Number	:	301-583-0001
Fax Number	:	301-583-3403

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

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	05/24/2026

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