Provider Demographics
NPI:1326592742
Name:ROXANNE OSTLUND LPC PLCC
Entity Type:Organization
Organization Name:ROXANNE OSTLUND LPC PLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OSTLUND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-722-0750
Mailing Address - Street 1:125 S CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4732
Mailing Address - Country:US
Mailing Address - Phone:540-722-0750
Mailing Address - Fax:
Practice Address - Street 1:125 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4732
Practice Address - Country:US
Practice Address - Phone:540-722-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006612101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty