Provider Demographics
NPI:1063522316
Name:TURK, KATHRYN FLEMING (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:FLEMING
Last Name:TURK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7448 OLD QUARRY LN
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1552
Mailing Address - Country:US
Mailing Address - Phone:440-838-4151
Mailing Address - Fax:440-526-0425
Practice Address - Street 1:7650 CHIPPEWA RD STE 300
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-2319
Practice Address - Country:US
Practice Address - Phone:440-838-4151
Practice Address - Fax:440-526-0425
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH831103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0855507Medicaid
OH831OtherPSYCHOLOGIST LICENSE
OHTUCP00591Medicare ID - Type UnspecifiedPROVIDER NUMBER