Provider Demographics
NPI:1093556649
Name:PROBUS, VONNA P (MA, LPCA)
Entity type:Individual
Prefix:
First Name:VONNA
Middle Name:P
Last Name:PROBUS
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSON
Mailing Address - State:KY
Mailing Address - Zip Code:42726-8060
Mailing Address - Country:US
Mailing Address - Phone:270-446-0125
Mailing Address - Fax:
Practice Address - Street 1:316 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1637
Practice Address - Country:US
Practice Address - Phone:270-377-7137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY268570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health