Provider Demographics
NPI:1427386994
Name:ROX, LACRESHA MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LACRESHA
Middle Name:MARIE
Last Name:ROX
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 MAYFIELD RD STE 112
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2608
Mailing Address - Country:US
Mailing Address - Phone:216-372-0349
Mailing Address - Fax:
Practice Address - Street 1:5001 MAYFIELD RD STE 112
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2608
Practice Address - Country:US
Practice Address - Phone:216-372-0349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-21
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH019798363LP0808X
OR202110895NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health