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General NPI Number Information
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NPI Number | 1215475256
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Entity Type | Individual
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Provider Name | LAURIE W CARLTON LPC
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Gender | Female
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 1102 SMITH AVE SUITE K
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City | THOMASVILLE
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State | GA
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Zip | 31792-5739
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Country | US
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Telephone | 229-225-5208
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Fax | 229-227-5458
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Provider Business Mailing Address
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Address Line | 100 CARRINGTON CIR
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City | THOMASVILLE
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State | GA
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Zip | 31757-2956
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Country | US
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Telephone | 229-403-9393
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Fax | 229-227-5458
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC009421
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License Number State | GA
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