1881723153 NPI number — MISS CHERYL DEMARUES TURNER LSCW BCD ALSW CBT

Table of content: MISS CHERYL DEMARUES TURNER LSCW BCD ALSW CBT (NPI 1881723153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881723153 NPI number — MISS CHERYL DEMARUES TURNER LSCW BCD ALSW CBT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
CHERYL
Provider Middle Name:
DEMARUES
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LSCW BCD ALSW CBT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881723153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30416
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-363-3852
Provider Business Mailing Address Fax Number:
718-773-6230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26 COURT STREET
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-363-3852
Provider Business Practice Location Address Fax Number:
718-773-6230
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X , with the licence number:  11521 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: R035633 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: R035633 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 29757 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02148341 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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