Individual
KAREN LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 687-1110
Mailing address
PO BOX 8549, COBURG, OR 97408-1313
(541) 687-1110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/07/2014
Last updated
02/13/2026
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