Individual provider Active NPI

Stephen Hans Stoltzfus, PSYD

  • Clinical Psychologist
  • Salem, OR
National Provider Identifier
1942866470
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3646 Issued in OR
Practice address
2601 25TH St SE Ste 420
Salem, OR 97302-1285
Phone
(503) 364-6093
Fax
(503) 364-5121
NPI assigned
May 9, 2019
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Psychologist 103TC0700X 3646 OR Primary

Addresses

Primary practice location

2601 25TH St SE Ste 420
Salem, OR 97302-1285

Mailing address

607 E 3Rd St
Newberg, OR 97132-3105

Other practice location 1

435 Lancaster Dr NE
Salem, OR 97301-4729
Phone (503) 585-7254

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231116001837 OR Practitioner - Clinical Psychologist 7315394012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Valley Counseling Center IncGroup PAC ID 2769479948, 13 clinicians

Practice addresses (Care Compare)

2250 D St NE
Salem, OR 97301-2768
Phone (503) 364-6093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3646ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Valley Counseling Center Inc Clinical CurrentSince Sep 1, 2024 Accepting new patients
Psych NW, PC CurrentSince Oct 4, 2023 Accepting new patients

Locations

2250 D St NE
Salem, OR 97301
Phone (503) 364-6093

2601 25th St SE
Ste 420
Salem, OR 97302
Phone (503) 364-6093

4068 Hudson Ave NE
Salem, OR 97301
Phone (503) 877-0711

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1942866470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E 3RD ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971323105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 25TH ST SE STE 420",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021285",
            "telephone_number": "503-364-6093",
            "fax_number": "503-364-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014729",
            "country_code": "US",
            "telephone_number": "503-585-7254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLTZFUS",
        "first_name": "STEPHEN",
        "middle_name": "HANS",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.