MEDICARE: SHANIYA JEAN TURNER

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
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1861098048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANIYA JEAN TURNER

Provider Business Mailing Address
First Line	:	1101 SUNSET RD UNIT 681753
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-0480
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 SUNSET RD UNIT 681753
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-0480
Country	:	US
Telephone Number	:	704-981-1287
Fax Number	:

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

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	12/23/2025

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