Stephanie Marie Conn, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2825 Issued in OR

Practice address

1791 NW 173Rd Ave Ste 140
Beaverton, OR 97006-5630

Phone

(503) 726-4449

NPI assigned

Sep 25, 2017

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

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 2, 2024 through Oct 2, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• First Responder Psychology

  • Counseling Psychologist
  • Beaverton, OR
  • NPI 1477124261
  NPD Authorized official

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1902315765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 NW 173RD AVE STE 140",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065630",
            "telephone_number": "503-726-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 NW 173RD AVE STE 140",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065630",
            "telephone_number": "503-726-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Compass Psychiatric Wellness LLC
• Complete Family Care
• Stacey Marie Condray
• Conerstone Chiropractic PS Inc
• Erin Marie Conley
• Corey Connare
• Connected Counseling & Wellness, LLC
• Dan James Connelly
• Kylie Conrad
• Lauren Patricia Elizabeth Constantine

• Psychologist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.