| Paula L Lawrence, CRC, LCPC, CADC | |
|
303 S Main St, Troy, IL 62294-1808 | |
| (618) 505-0784 | |
| (618) 505-0785 |
| Full Name | Paula L Lawrence |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 303 S Main St, Troy, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154695047 | NPI | - | NPPES |
| 00275446 | Other | IL | COMMISSION ON REHABILITATION COUNSELOR CERTIFICATION |
| 271000235 | Other | IL | STATE LICENSE |
| 180012544 | Other | IL | STATE LICENSE |
| 272000224 | Other | IL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 180012544 (Illinois) | Primary |
| 225C00000X | Rehabilitation Counselor | 00275446 (Illinois) | Secondary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Paula L Lawrence, CRC, LCPC, CADC 303 S Main St, Troy, IL 62294-1808 Ph: (618) 505-0784 | Paula L Lawrence, CRC, LCPC, CADC 303 S Main St, Troy, IL 62294-1808 Ph: (618) 505-0784 |
Mrs. Evonne M. Kuckuck, LCPC, ATR Counselor Medicare: Not Enrolled in Medicare Practice Location: 552 Edwardsville Rd, Troy, IL 62294 Phone: 618-531-2435 | |
Jennifer Wildhaber, ATR LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 189 E Us Highway 40 Ste D, Troy, IL 62294 Phone: 618-979-2336 Fax: 618-505-5044 | |
William Lee Bishop, L.C.S.W. Counselor Medicare: Not Enrolled in Medicare Practice Location: 132 Taylor Lake Dr, Troy, IL 62294 Phone: 618-314-0172 | |
Ashlynn Kaye Pinney, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1008 Troy Ofallon Rd, Troy, IL 62294 Phone: 618-972-1568 Fax: 618-205-3561 | |
Samantha N Allan, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Ohara Dr, Troy, IL 62294 Phone: 618-816-5255 | |
Gena Haile, Counselor Medicare: Not Enrolled in Medicare Practice Location: 303 S Main St, Troy, IL 62294 Phone: 618-505-0784 Fax: 618-505-0785 |