Provider Demographics
NPI:1598461642
Name:TURNER, STACIA (LGCP)
Entity type:Individual
Prefix:
First Name:STACIA
Middle Name:
Last Name:TURNER
Suffix:
Gender:X
Credentials:LGCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11805 CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-4721
Mailing Address - Country:US
Mailing Address - Phone:480-390-2152
Mailing Address - Fax:
Practice Address - Street 1:11805 CHARLES RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4721
Practice Address - Country:US
Practice Address - Phone:480-390-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGCP200001842101YM0800X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374J00000XNursing Service Related ProvidersDoula