Provider Demographics
NPI:1447552195
Name:TURNER, KELLY ELIZABETH (LCSW)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ELIZABETH
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 1:2315 W NORTH A ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2381
Mailing Address - Country:US
Mailing Address - Phone:443-621-0976
Mailing Address - Fax:
Practice Address - Street 1:5121 EHRLICH RD
Practice Address - Street 2:BLDG 101 STE G
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2049
Practice Address - Country:US
Practice Address - Phone:443-621-0976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 10014104100000X
MD147731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical