Provider Demographics
NPI:1033868468
Name:GREEN, LAURA HEYMANN (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HEYMANN
Last Name:GREEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E MAIN ST UNIT 404
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3468
Mailing Address - Country:US
Mailing Address - Phone:914-227-0126
Mailing Address - Fax:
Practice Address - Street 1:1 E MAIN ST UNIT 404
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3468
Practice Address - Country:US
Practice Address - Phone:914-227-0126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health