Provider Demographics
NPI:1902238744
Name:TURNER, KELLY (LMFT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W DIXIE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-1586
Mailing Address - Country:US
Mailing Address - Phone:270-491-0204
Mailing Address - Fax:
Practice Address - Street 1:240 W DIXIE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-1586
Practice Address - Country:US
Practice Address - Phone:270-491-0204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-03
Last Update Date:2013-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0850106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist