Healthcare Provider Details

I. General information

NPI: 1255281135
Provider Name (Legal Business Name): INTEGRATED COUNSELING LLC LAURA J VANCARA LPC NCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 VIRGINIA AVE STE 215
NORTH BEND OR
97459-2729
US

IV. Provider business mailing address

1630 S 16TH ST
COOS BAY OR
97420-1033
US

V. Phone/Fax

Practice location:
  • Phone: 541-808-4312
  • Fax: 541-982-7295
Mailing address:
  • Phone: 541-828-4312
  • Fax: 541-982-7295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. LAURA JANE VANCARA
Title or Position: LPC, OWNER
Credential: LPC, NCC
Phone: 541-808-4312