Provider Demographics
NPI:1003142779
Name:GALLISON, LAUREN MARIE (MS, LPCA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:GALLISON
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MARIE
Other - Last Name:GRIGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, QP
Mailing Address - Street 1:301 ADDISON POINTE DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-3409
Mailing Address - Country:US
Mailing Address - Phone:843-602-5759
Mailing Address - Fax:
Practice Address - Street 1:110 W WALKER AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6760
Practice Address - Country:US
Practice Address - Phone:336-633-7000
Practice Address - Fax:336-625-3817
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health