Healthcare Provider Details

I. General information

NPI: 1700709375
Provider Name (Legal Business Name): ROXY ANN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N CENTRAL AVE STE 213
MEDFORD OR
97501-5939
US

IV. Provider business mailing address

1104 E JACKSON ST
MEDFORD OR
97504-7029
US

V. Phone/Fax

Practice location:
  • Phone: 541-690-8756
  • Fax: 458-203-5051
Mailing address:
  • Phone: 888-556-7282
  • Fax: 458-203-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LACEY WATSON
Title or Position: OWNER
Credential:
Phone: 541-973-7333