Provider Demographics
NPI:1689215006
Name:BRYAN, LAURA (LPC, LPCC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BRYAN
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 WESTEN ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3352
Mailing Address - Country:US
Mailing Address - Phone:270-904-1072
Mailing Address - Fax:
Practice Address - Street 1:2720 CREEL LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4277
Practice Address - Country:US
Practice Address - Phone:817-597-9680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health