Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Laroy Lackey

Individual provider Mental Health Counselor · NPI 1780982454

Laroy Lackey is a Mental Health Counselor in Fairview, Oregon. Practices as a sole proprietor. Registered with an NPI since 2011.

In the registry since
2011

Practice location Address checks out

1945 NE 205th Ave
Fairview, OR 97024-9622
Phone: (503) 661-8050
Fax: (503) 492-4651
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence PROFESSIONALLICENSE

Record details

NPI number1780982454
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 4, 2011
Last updated in NPPESNovember 1, 2023
Certification dateJune 14, 2022
Mailing address3587 Heathrow Way, Medford, OR 97504-4004

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