Active NPI
Scott Stacey, CRM
- Addiction (Substance Use Disorder) Counselor
- Redmond, OR
National Provider Identifier
1467988345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 17-CRM-081
- Practice address
- 340 NW 5TH St
Box 1710
Redmond, OR 97756-1869 - Phone
- (541) 516-4087
- Fax
- (541) 504-1195
- NPI assigned
- May 11, 2017
- Last updated
- May 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17-CRM-081 | OR | Primary |
Addresses
Primary practice location
340 NW 5TH St
Box 1710
Redmond, OR 97756-1869
Mailing address
461 NE Greenwood Ave
Bend, OR 97701-4607
Phone (541) 617-7365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-CRM-081 | OR | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1467988345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 NE GREENWOOD AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977014607",
"telephone_number": "541-617-7365",
"fax_number": "541-504-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 NW 5TH ST",
"address_2": "BOX 1710",
"city": "REDMOND",
"state": "OR",
"postal_code": "977561869",
"telephone_number": "541-516-4087",
"fax_number": "541-504-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACEY",
"first_name": "SCOTT",
"credential": "CRM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-11",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "17-CRM-081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
- St. Charles Health System, Inc. (St. Charles Sleep Center - Redmond)
- St. Charles Health System, Inc. (St. Charles OB/GYN - Redmond)
- St. Charles Health System, Inc. (The Center at St. Charles Medical Equipment)
- St. Charles Health System, Inc. (St. Charles Pulmonary Clinic - Redmond)
- St. Charles Health System, Inc. (St. Charles Cancer Center - Redmond)
- William Stacy, LPTA
- Tiffany Stadler, LPC, M.ED
- Kady Stafford, LPC
- Madeline Staiger, DPT
- Kaila Starmer, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.