STACY ANN WILSON (NPI# 1386277150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386277150 |
| Entity Type | Individual |
| Full Name | STACY ANN WILSON |
| Credential | CRM |
| Practice Address |
2901 E Burnside St Portland OR 97214-1831 |
| Practice Telephone | 5032385203 |
| Mailing Telephone | 5032385203 |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 20-CRM-007 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992261085 | Stacy Natasha Wilson | Counselor | 145 Parker Fishery Rd, Winton, NC 27986-9763 | 2019-02-14 |
| 1194215244 | Stacy Wilson | Registered Nurse | 1601 Ulupuni St, Kailua, HI 96734-4452 | 2018-05-15 |
| 1396276747 | Stacy Wilson | Specialist | 189 Lake St, Oceanside, NY 11572-4212 | 2017-03-27 |
| 1174898365 | Stacy Wilson | Rehabilitation Practitioner | 4233 Pelican Dr, Fallon, NV 89406-2445 | 2012-03-20 |
| 1114236346 | Stacy Allieou Wilson | Occupational Therapist | 4920 Raeford Rd, Fayetteville, NC 28304-3142 | 2010-10-06 |
| 1952862963 | Stacy Wilson | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Msag407p, Temple, TX 76508-0001 | 2019-03-31 |
| 1326507815 | Stacy Wilson | Social Worker | 52 Woodstream Dr, Grand Island, NY 14072 | 2019-03-14 |
| 1881103885 | Stacy J Wilson | Occupational Therapy Assistant | 3355 E Semoran Blvd, Apopka, FL 32703-6062 | 2017-09-22 |
| 1386162436 | Stacy Caye Wilson | Counselor | 505 Coates St, Parkersburg, IA 50665-7733 | 2017-09-08 |
| 1194276584 | Stacy Marie Wilson | Licensed Practical Nurse | 127 East State Street, Gloversville, NY 12078-1204 | 2016-10-20 |
| Street Address |
2901 E BURNSIDE ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97214-1831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871542647 | Gloria Jean Nepstead | Acupuncturist | 2901 E Burnside St, Portland, OR 97214-1831 | 2006-05-09 |
| 1508416546 | Gracie James Dilley-bucciarelli | Counselor | 2901 E Burnside St, Portland, OR 97214-1831 | 2019-09-11 |
| 1396391496 | Kalee Summer Hoyt | Counselor | 2901 E Burnside St, Portland, OR 97214-1831 | 2019-08-14 |
| 1194377416 | Jennifer Benson | Social Worker | 2901 E Burnside St, Portland, OR 97214-1831 | 2019-07-16 |
| 1285294637 | Allison Marie Haws | Case Manager/Care Coordinator | 2901 E Burnside St, Portland, OR 97214-1831 | 2019-06-18 |
| 1538620992 | Maleka Taylor | Case Manager/Care Coordinator | 2901 E Burnside St, Portland, OR 97214-1831 | 2019-03-28 |
| 1447720784 | Yevgeniya Gluzberg | Peer Specialist | 2901 E Burnside St, Portland, OR 97214-1831 | 2018-11-29 |
| 1124505391 | Sundaura Lithman | Counselor | 2901 E Burnside St, Portland, OR 97214-1831 | 2018-07-20 |
| 1619453057 | Lydia Cortez-hickox | Peer Specialist | 2901 E Burnside St, Portland, OR 97214-1831 | 2018-07-18 |
| 1417443318 | Teresa Ann Conner | Social Worker | 2901 E Burnside St, Portland, OR 97214-1831 | 2018-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1336772243 | Alexandra Mcbryde | Acupuncturist | 959 Se Division St, #315, Portland, OR 97214 | 2020-02-19 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1639616436 | Erin Elizabeth Weaver | Acupuncturist | 1330 Se Cesar E Chavez Blvd. Center for Natural Meidici, Portland, OR 97214 | 2017-01-31 |
| 1780126045 | Katherine Aravamudan, Lpc, LLC | Community/Behavioral Health | 1312 E. Burnside Street, Portland, OR 97214 | 2016-11-17 |
| 1003358441 | Michelle Jean Meadows | Massage Therapist | 2804 Se Lincoln St, Portland, OR 97214 | 2016-11-16 |
| 1629429311 | Stephanie Tolentino | Counselor | 605 Se Cesar E Chavez Blvd., Portland, OR 97214 | 2016-06-24 |
| 1790141166 | Marian Iris Dixon | Massage Therapist | 3810 Se Belmont St., Earthbody Wellness Center East, Portland, OR 97214 | 2016-01-14 |
| 1194194589 | Lutheran Community Services Northwest | Community/Behavioral Health | 605 Se Cesar E Chavez Bld, Portland, OR 97214 | 2015-09-16 |
| 1497123566 | Michele R. Stokes | Specialist | 2311 East Burnside B1, Portland, OR 97214 | 2015-09-08 |
| Find all providers in zip 97214 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on STACY ANN WILSON.
| 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.