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Laroy Lackey
Mental Health Counselor in Fairview, Oregon
NPI 1780982454

Laroy Lackey is a Mental Health Counselor based in Medford, OR and is specialized in Mental Health. Laroy Lackey practices in Fairview, OR. The NPI Number for Laroy Lackey is 1780982454 and holds a License No. PROFESSIONALLICENSE (Oregon).

The current practice location address for Laroy Lackey is 1945 Ne 205Th Ave, Fairview, OR and can be reached out via phone at 503-661-8050 and via fax at 503-492-4651.

Location: 1945 Ne 205Th Ave, Fairview, OR, 97504-4004
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780982454
Provider Name
Laroy Lackey
Credential
Provider Entity Type
Individual
Gender
Male
Address
1945 Ne 205Th Ave, Fairview, OR, 97504-4004
Phone Number
503-661-8050
Fax Number
503-492-4651
Provider Enumeration Date
03/04/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1945 Ne 205Th Ave
City
Fairview
State
Oregon
Zip
97024-9622
Phone Number
503-661-8050
Fax Number
503-492-4651
person
Provider Business Mailing Address Details
Address
1945 Ne 205Th Ave
City
Fairview
State
Oregon
Zip
97024-9622
Phone Number
503-661-8050
Fax Number
503-492-4651
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
PROFESSIONALLICENSE ()
Definition
Definition to come...
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