Provider Demographics
NPI:1871366575
Name:TURNER, NICOLE (LICSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:GILBERTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:36908-0041
Mailing Address - Country:US
Mailing Address - Phone:205-457-2689
Mailing Address - Fax:
Practice Address - Street 1:112 MELVIN ROAD
Practice Address - Street 2:
Practice Address - City:GILBERTOWN
Practice Address - State:AL
Practice Address - Zip Code:36908-5722
Practice Address - Country:US
Practice Address - Phone:251-843-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4869C1041C0700X
AL48691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical