Provider Demographics
NPI:1326855834
Name:TURNER, LAVONNE CHERYL (LLPC)
Entity type:Individual
Prefix:
First Name:LAVONNE
Middle Name:CHERYL
Last Name:TURNER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16844 WINSTON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3662
Mailing Address - Country:US
Mailing Address - Phone:313-268-6625
Mailing Address - Fax:
Practice Address - Street 1:359 LIVERNOIS ST # 102
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2301
Practice Address - Country:US
Practice Address - Phone:313-831-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty