OrganizationActive
Serenity Lane
NPI 1073060182 · Addiction (Substance Use Disorder) Counselor · Roseburg, OR
Provider details
- NPI number
- 1073060182
- Entity type
- Organization
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Anthony Haynes, Program Coordinator(541) 673-3504
- License
- 13-12-59 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2575 Nw Kline St
Roseburg, OR 97471-8827
Phone: (541) 673-3504
Fax: (541) 673-4724
Street-level locationGet directions
Mailing address
2575 Nw Kline St
Roseburg, OR 97471-8827
Registry dates
- Enumerated
- 2016-09-07
- Last updated
- 2016-09-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.