Provider Demographics
NPI:1770039240
Name:GREEN, LAUREN (MS, NCC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4314
Mailing Address - Country:US
Mailing Address - Phone:208-989-3120
Mailing Address - Fax:
Practice Address - Street 1:701 N CENTRAL ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-7258
Practice Address - Country:US
Practice Address - Phone:208-989-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health