Stacy J Williams, CADC I, CRM

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18-P-02 Issued in OR

Practice address

525 Ferry St SE Ste 203
Salem, OR 97301-3743

Phone

(503) 363-0833

Fax

(503) 363-0833

NPI assigned

May 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527465600000",
    "number": "1154812923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BRENNA AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018056",
            "telephone_number": "971-218-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 FERRY ST SE STE 203",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013743",
            "telephone_number": "503-363-0833",
            "fax_number": "503-363-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STACY",
        "middle_name": "J",
        "credential": "CADC I, CRM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2018-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "18-P-02",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark D. Williams, PA-C
• Michael Howard Williams, LPC
• Nicholas Andrew Williams, PA-C
• Rebecca Erin Williams, RPH
• Sierra Noelle Williams, MSW, QMHP
• Suzanne Williams, PSY.D.
• Thomas J. Williams, P.T
• William Earle Williams, PA C
• Joan M Williamson, LPC
• Tom Williamson, B.S.

• Addiction (Substance Use Disorder) Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2018; 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.