Provider Demographics
NPI:1427237981
Name:TURNER, NICOLE RENEE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:RENEE
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 1:2128 N WHIPPLE ST
Mailing Address - Street 2:APT 2S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3800
Mailing Address - Country:US
Mailing Address - Phone:773-716-7150
Mailing Address - Fax:
Practice Address - Street 1:2128 N WHIPPLE ST
Practice Address - Street 2:APT 2S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-3800
Practice Address - Country:US
Practice Address - Phone:773-716-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0126511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical