Provider Demographics
NPI:1780970335
Name:CRIBBS, LAURA CHRISTEN (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CHRISTEN
Last Name:CRIBBS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTEN
Other - Middle Name:BALES
Other - Last Name:CRIBBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2107 MATHIS DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2849
Mailing Address - Country:US
Mailing Address - Phone:229-300-7207
Mailing Address - Fax:
Practice Address - Street 1:2107 MATHIS DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2849
Practice Address - Country:US
Practice Address - Phone:229-300-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005833101YP2500X
GA005833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional