Provider Demographics
NPI:1215308911
Name:TURNER, TAWANA RACHELLE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:TAWANA
Middle Name:RACHELLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ORPHANAGE RD
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3006
Mailing Address - Country:US
Mailing Address - Phone:859-331-2040
Mailing Address - Fax:859-331-1614
Practice Address - Street 1:75 ORPHANAGE RD
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-331-0821
Practice Address - Fax:859-331-1614
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2532701041C0700X
OHS.1450714104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical