Stacey Keleen Harris, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17834 Issued in OR

Practice address

33461 SE Peoria Rd
Corvallis, OR 97333-2521

Phone

(541) 704-4010

NPI assigned

May 11, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1093337230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 NW FILLMORE AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305165",
            "telephone_number": "406-304-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33461 SE PEORIA RD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332521",
            "telephone_number": "541-704-4010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2963 NW Fillmore Ave",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305165",
            "country_code": "US",
            "telephone_number": "406-304-8330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "STACEY",
        "middle_name": "KELEEN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SLP-SP-LIC-9724",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "MT-SLP-SP-LIC-9724",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Harris, R.D., L.D., C.N.S.C
• Justin Henry Washburn Harris, DO
• Keith E Harris, MD
• Michael P Harris
• Pernell Caroline Harris
• Harrison Counseling and Consulting LLC
• Hilary J Harrison
• Jacob Harrison, MA
• Kari Kishin Lindahl Hart, MSW, CSWA, CGACI
• Kayla Corrine Hart

• Speech-Language Pathologist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.