Provider Demographics
NPI:1548554215
Name:TURNER, MICHEL REESE (MED, LCAS)
Entity type:Individual
Prefix:MR
First Name:MICHEL
Middle Name:REESE
Last Name:TURNER
Suffix:
Gender:M
Credentials:MED, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 N HERRITAGE ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1580
Mailing Address - Country:US
Mailing Address - Phone:252-520-6740
Mailing Address - Fax:
Practice Address - Street 1:2902 N HERRITAGE ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1580
Practice Address - Country:US
Practice Address - Phone:252-520-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1642101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)