Provider Demographics
NPI:1063054344
Name:TURK, GENTRY (MA, LMHC, SUDP)
Entity type:Individual
Prefix:
First Name:GENTRY
Middle Name:
Last Name:TURK
Suffix:
Gender:F
Credentials:MA, LMHC, SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9125 BRIDGEPORT WAY SW STE 102
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2448
Mailing Address - Country:US
Mailing Address - Phone:253-235-3354
Mailing Address - Fax:
Practice Address - Street 1:9125 BRIDGEPORT WAY SW STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2448
Practice Address - Country:US
Practice Address - Phone:253-235-3354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)