Active NPI
Stanley Charles McNeil, PSY.D.
- Clinical Psychologist
- Gladstone, OR
National Provider Identifier
1720163272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1378
- Practice address
- 250 Princeton Ave.
Suite 203
Gladstone, OR 97027-2554 - Phone
- (503) 657-4558
- Fax
- (503) 656-4618
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1378 | OR | Primary |
Addresses
Primary practice location
250 Princeton Ave.
Suite 203
Gladstone, OR 97027-2554
Mailing address
250 Princeton Ave.
Suite 203
Gladstone, OR 97027-2554
Phone (503) 657-4558
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 |
|---|---|---|---|
| 1378 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244592000000",
"number": "1720163272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 PRINCETON AVE.",
"address_2": "SUITE 203",
"city": "GLADSTONE",
"state": "OR",
"postal_code": "970272554",
"telephone_number": "503-657-4558",
"fax_number": "503-656-4618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 PRINCETON AVE.",
"address_2": "SUITE 203",
"city": "GLADSTONE",
"state": "OR",
"postal_code": "970272554",
"telephone_number": "503-657-4558",
"fax_number": "503-656-4618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNEIL",
"first_name": "STANLEY",
"middle_name": "CHARLES",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2009-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladstone, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.