Black, Laura

Black, Laura is an individual health care provider with primary practice located at 380 Suwannee Trail St , Bowling Green KY 42103-7956. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Black, Laura can be contacted via phone (270) 901-5000.

Contact Information

Primary practice address
380 Suwannee Trail St Bowling Green KY 42103-7956
Phone: (270) 901-5000
Fax: (270) 842-5268
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X 171471 Kentucky

Profile Details

NPI number 1043695927
LBN Legal business name Black, Laura
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2015
Last updated Nov 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043695927 NPPES
Kentucky MEDICAID 7100439620

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