Provider Demographics
NPI:1235842295
Name:TURNER, GEORGIA ANNETTE (EDD)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:ANNETTE
Last Name:TURNER
Suffix:
Gender:
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3237 SCHNEITER AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-1937
Mailing Address - Country:US
Mailing Address - Phone:502-396-9630
Mailing Address - Fax:
Practice Address - Street 1:1600 W SAINT CATHERINE ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40210-2442
Practice Address - Country:US
Practice Address - Phone:502-396-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY282440101Y00000X, 175T00000X
KY297698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No175T00000XOther Service ProvidersPeer Specialist