MRS. STACEY MARLENE KELLER (NPI# 1316590144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316590144 |
| Entity Type | Individual |
| Full Name | MRS. STACEY MARLENE KELLER |
| Credential | LCSW |
| Practice Address |
4400 Ne Halsey St Portland OR 97213-1545 |
| Mailing Address |
4204 Se 63rd Ave Portland OR 97206-3767 |
| Practice Telephone | 9712633942 |
| Mailing Telephone | 5038198903 |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2019-07-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
L7752 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275942567 | Stacey Ann Keller | Physical Therapist | 1512 W Service Dr, Winona, MN 55987-2540 | 2014-08-12 |
| 1831441831 | Stacey Lynn Keller | Physician Assistant | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2012-10-15 |
| 1205116787 | Stacey Lynn Keller | Pharmacist | 1108 Hartman Ln, Belleville, IL 62221-7921 | 2011-08-28 |
| 1720276306 | Stacey M Keller | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2007-10-09 |
| Street Address |
4400 NE HALSEY ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-1545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528089026 | Sonel P Patel | Family Medicine | 4400 Ne Halsey St, Building 2, Portland, OR 97213-1545 | 2006-07-21 |
| 1962046292 | Ligia Daniela Andersen | Registered Nurse | 4400 Ne Halsey St, Building 1 Ste 200, Portland, OR 97213-1545 | 2019-10-30 |
| 1194377960 | Anne M Thibodeaux | Pharmacist | 4400 Ne Halsey St, Portland, OR 97213-1545 | 2019-07-11 |
| 1598248072 | Katelyn Boel | Pharmacist | 4400 Ne Halsey St, Building 2, 4th Floor, Portland, OR 97213 | 2018-09-11 |
| 1851836076 | Valerie Fong | Registered Nurse | 4400 Ne Halsey St, Pop2, 3rd Fl, Portland, OR 97213-1545 | 2016-12-23 |
| 1912458241 | Yunuo Wu | Pharmacist | 4400 Ne Halsey St, 4th Floor, Building 2, Portland, OR 97213-1545 | 2016-10-21 |
| 1790232494 | Ghazaleh Sharifi | Pharmacist | 4400 Ne Halsey St, Building 2, 4th Floor, Portland, OR 97213-1545 | 2016-09-09 |
| 1003363797 | Clara Mikhaeil | Pharmacist | 4400 Ne Halsey St, Building 2 Suite 490, Portland, OR 97213-1545 | 2016-09-09 |
| 1669929410 | Benjamin Adam Rosati | Pharmacist | 4400 Ne Halsey St, Portland, OR 97213-1545 | 2016-09-08 |
| 1164979001 | Brianna Sue Patacini | Pharmacist | 4400 Ne Halsey St, Suite 490, Portland, OR 97213-1545 | 2016-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.