Stephanie Maria Canales Basurto

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T2451 Issued in OR

Practice address

12636 SE Stark St Ste 125
Portland, OR 97233-1058

Phone

(503) 253-4600

Fax

(503) 253-4609

NPI assigned

Jan 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Counselor, OR

  Medicare reassignment Care Compare group NPD
• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731

  Counselor

  NPD

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1851838767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST STE 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-253-4600",
            "fax_number": "503-253-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST STE 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-253-4600",
            "fax_number": "503-253-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANALES BASURTO",
        "first_name": "STEPHANIE",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T2451",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "22-12-10524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariana Campos
• Yvonne Campos
• Katherine Canada, MSW
• Spenser David Canada
• Nicole Alexis Canale, MPT
• Emma Kathryn Canales
• Tamera K Canales, CD(DONA)
• Amaris Canas, PA-C
• Heather Canby
• Yaira Canchola

• Marriage & Family Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.