Basic Information
| Provider Information | |||||||||
| NPI: | 1003846601 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6506 PLANTATION FOREST DR | ||||||||
| Address2: | |||||||||
| City: | SPOTSYLVANIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225537600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405828612 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7424 BROCK RD | ||||||||
| Address2: | |||||||||
| City: | SPOTSYLVANIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225532002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405823980 | ||||||||
| FaxNumber: | 5403713753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701002635 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 261789 | 01 | VA | MDIPA | OTHER | 4945123 | 05 | VA | MEDICAID | 082769 | 01 | VA | SENTARA | OTHER | 272608 | 01 | VA | ANTHEM | OTHER |