Laura Green, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

103 E Liberty LN
Danville, IL 61832-1442

Phone

(309) 704-0034

NPI assigned

May 10, 2021

Last updated

Aug 22, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Laura Tallon Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Two Roads Wellness Clinic, LLCGroup PAC ID 9638536220, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL HMO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Two Roads Wellness Clinic, LLC

  dba Two Roads Wellness Clinic

  • Primary Care Nurse Practitioner
  • Danville, IL
  • NPI 1417329426
  Medicare reassignment Care Compare group NPD
• Two Roads Wellness Clinic, LLC

  • Primary Care Clinic/Center
  • Covington, IN
  • NPI 1639927296
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1003490673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E LIBERTY LN",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321442",
            "telephone_number": "309-704-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E LIBERTY LN",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321442",
            "telephone_number": "309-704-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LAURA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "TALLON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith S Grant, BS, MHP
• Monica G Grant, MA, CCC-A, FAAA
• Emily Joan Graver
• Richard Allen Graves, M.A. CCC-A
• Damon C. Green, M.D.
• Patsy Ann Green, RN, CDE
• Danny Robert Grider, O.D.
• Mary Ellen Grilly, DDS
• Bradley Wayne Grissom, N.P.
• Haley Madison Grove

• Mental Health Counselor in Danville, IL
• Providers in Danville, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.