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Provider Information for 1154695047


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PAULA L LAWRENCE CRC, LCPC, CADC


Sex: Female

NPI: 1154695047
Last Updated: 2024-12-21
Certification Date: 2024-12-21

Details

NameValue
NPI1154695047
Enumeration Date2012-02-24
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 303 S MAIN ST
TROY, IL 62294-1808
United States

Phone: 618-505-0784 | Fax:618-505-0785
 
Primary Practice Address 303 S MAIN ST
TROY, IL 62294-1808
United States

Phone: 618-505-0784 | Fax:618-505-0785
 
Secondary Practice Address(es)

123 S 10TH ST STE 502
MOUNT VERNON, IL 62864-4028
United States

Phone: 618-505-0784 | Fax:618-505-0785
 

208 N MARKET ST UNIT 1
MARION, IL 62959-2465
United States

Phone: 618-505-0784 | Fax:618-505-0785
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Direct Messaging Address
paula@choicescounseling.us
303 S Main St
Troy, IL 62294-1808
United States
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)IL00275446Commission on Rehabilitation Counselor Certification
Other (non-Medicare)IL180012544State license
Other (non-Medicare)IL271000235State License
Other (non-Medicare)IL272000224State License
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YA0400X - Counselor - Addiction (Substance Use Disorder)IL180012544
No 225C00000X - Rehabilitation Counselor IL00275446