Healthcare Provider Details

I. General information

NPI: 1891599056
Provider Name (Legal Business Name): MRS. LAURA GRACE COEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 SPINK ST
WOOSTER OH
44691-3652
US

IV. Provider business mailing address

1062 TOWNSHIP ROAD 1906
ASHLAND OH
44805-9419
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-8498
  • Fax:
Mailing address:
  • Phone: 419-651-6879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2608026
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2405859-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: