STACY J NIELSEN, LCSW, LLC (NPI# 1861843310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861843310 |
| Entity Type | Organization |
| Organization Name | STACY J NIELSEN, LCSW, LLC |
| Practice Address |
11 Sw Brantley Dr Winston OR 97496-4526 |
| Mailing Address |
11 Sw Brantley Dr Winston OR 97496 |
| Practice Telephone | 5416790366 |
| Mailing Telephone | 5416790366 |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-06-27 |
| Authorized Official Name | STACY JEAN NIELSEN (OWNER) |
| Authorized Official Telephone | 5418026597 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | L6376 | OR | Agencies |
| Street Address |
11 SW BRANTLEY DR |
| City | WINSTON |
| State | OR |
| Zip Code | 97496-4526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154944536 | Functional Mental Health | Nurse Practitioner | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2020-05-20 |
| 1023649605 | Jenny V Tausch | Nurse Practitioner | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2020-01-31 |
| 1639698350 | Jeffrey Wheeler | Social Worker | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2017-09-13 |
| 1932551165 | Mckenzie Smith | Nurse Practitioner | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2016-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679957708 | Second Wind Mental Health Clinic | Clinic/Center | 11 Sw Brantley Drive, Winston, OR 97496 | 2015-07-18 |
| 1992951305 | Ronald Forrest Tribble | Dentist | 90 Nw Glenhart, Winston, OR 97496 | 2008-08-18 |
| 1396923884 | Karen S Triplett | Nurse Practitioner | 92 Nw Glenhart Ave, Winston, OR 97496 | 2008-02-06 |
| 1629168166 | Adolescent Day Treatment Center Inc of Douglas County | Clinic/Center | 671 S.w. Main, Winston, OR 97496 | 2006-10-13 |
| 1184610123 | Ronald F. Tribble, Dmd, PC | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496 | 2005-09-26 |
| 1083016695 | Cora G Hart | Psychologist | 671 Sw Main St, Winston, OR 97496 | 2014-09-25 |
| 1912160169 | Kathryn Elizabeth Dailey | Social Worker | 671 Sw Main, Winston, OR 97496 | 2008-07-08 |
| 1912061755 | Adapt | Family Medicine | 671 Sw Main, Winston, OR 97496-0012 | 2006-12-19 |
| 1144426271 | Rebecca Lin Duffy | Nurse Practitioner | 311 Sw Main, Winston, OR 97496-0771 | 2007-06-25 |
| 1033462866 | Kathryn Vara | Registered Nurse | 77 Sw Brantley Dr, Winston, OR 97496-4526 | 2012-10-17 |
| Find all providers in zip 97496 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607464 | Rogue Therapy | Community/Behavioral Health | 328 S Central Ave Ste 213, Medford, OR 97501-7274 | 2020-10-24 |
| 1710586821 | Plum Consulting LLC | Community/Behavioral Health | 1161 Nw Overton St Apt 1501, Portland, OR 97209-2549 | 2020-10-20 |
| 1598375990 | Inspire Wellness Counseling | Community/Behavioral Health | 535 River St, Cave Junction, OR 97523-1170 | 2020-07-31 |
| 1184247850 | Altoris Behavior Support LLC | Community/Behavioral Health | 3880 Se 8th Ave Ste 105, Portland, OR 97202-3772 | 2020-05-28 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1548889272 | Nami of Washington County | Community/Behavioral Health | 18680 Sw Shaw St, Aloha, OR 97078-1250 | 2020-04-13 |
| 1689203515 | New Summit Behavioral Therapy, LLC | Community/Behavioral Health | 1056 Green Acres Rd # 102-360, Eugene, OR 97408-1505 | 2020-04-02 |
| 1033749825 | Erica D. Prince, Phd, LLC | Community/Behavioral Health | 2945 Nw Mulkey Ave, Corvallis, OR 97330-1836 | 2020-01-21 |
| 1578102216 | Act Nw | Community/Behavioral Health | 909 Nw 24th Ave, Portland, OR 97210-3009 | 2019-12-28 |
| 1154969772 | Columbia Community Mental Health | Community/Behavioral Health | 58581 Columbia River Hwy, Saint Helens, OR 97051-3225 | 2019-12-13 |
| Find all providers with the same taxonomy | ||||
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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.