Provider Demographics
NPI:1154429587
Name:TURNICK, ELLEN MARY (RN, LPC)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARY
Last Name:TURNICK
Suffix:
Gender:F
Credentials:RN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 N PARK RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2912
Mailing Address - Country:US
Mailing Address - Phone:610-375-0544
Mailing Address - Fax:610-378-9779
Practice Address - Street 1:716 N PARK RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2912
Practice Address - Country:US
Practice Address - Phone:610-375-0544
Practice Address - Fax:610-378-9779
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN269166L163WP0808X
PAPC005371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health