Individual provider · Type 1 NPI

Alexus Pettibone

Mental Health Counselor · Roseburg, OR

NPI number 1316745359 Active

Practice location

548 SE Jackson St
Roseburg, OR 97470-4983

Call (541) 440-3532 Map

Mailing address

PO Box 1121
Roseburg, OR 97470-0254

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1316745359

Alexus Pettibone's National Provider Identifier is 1316745359, issued on Mar 5, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Roseburg, OR. The record was last updated on Mar 5, 2025.