Provider Demographics
NPI:1194880096
Name:TURNER, LESLIE A (LCSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:TURNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 N. MONTGOMERY STREET
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648
Mailing Address - Country:US
Mailing Address - Phone:814-695-2200
Mailing Address - Fax:814-695-2204
Practice Address - Street 1:413 N. MONTGOMERY STREET
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648
Practice Address - Country:US
Practice Address - Phone:814-695-2200
Practice Address - Fax:814-695-2204
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW013385L104100000X
PA1041C0700X
PACW0171711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102390893Medicaid
PA1029365050001Medicaid
PA1023908930002Medicaid