Individual
LAURA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
840 INTERSTATE DR, GRAYSON, KY 41143-1768
(866) 233-1955
(606) 473-7335
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
247159
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
245089
KY
101YP2500X
Professional Counselor
Primary
272556
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
09/09/2009
Last updated
02/28/2025
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