Laura Green, LCSW | |
103 E Liberty Ln, Danville, IL 61832-1442 | |
(309) 704-0034 | |
Not Available |
Full Name | Laura Green |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 103 E Liberty Ln, Danville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003490673 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Two Roads Wellness Clinic, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417329426 PECOS PAC ID: 9638536220 Enrollment ID: O20230613003222 |
Mailing Address | Practice Location Address |
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Laura Green, LCSW 103 E Liberty Ln, Danville, IL 61832-1442 Ph: (309) 704-0034 | Laura Green, LCSW 103 E Liberty Ln, Danville, IL 61832-1442 Ph: (309) 704-0034 |
Mrs. Jamie Renee Meagher, BS, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 210 Avenue C, Danville, IL 61832 Phone: 217-442-3200 Fax: 217-442-7460 | |
Shakela Mcwaine, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3545 N Vermilion St, Danville, IL 61832 Phone: 217-651-6801 Fax: 217-651-6802 | |
Katherine Brewer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 800 Oak St, Danville, IL 61832 Phone: 217-504-0131 | |
Mrs. Susan Perkins, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 210 Avenue C, Danville, IL 61832 Phone: 217-442-3200 Fax: 217-442-7460 | |
Madison Manint, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3545 N Vermilion St, Danville, IL 61832 Phone: 217-651-6801 | |
Ms. Randi D Jones, BA, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 210 Avenue C, Danville, IL 61832 Phone: 217-442-3200 Fax: 217-442-7460 |