MR. STACEY WARREN BERRY (NPI# 1942702014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942702014 |
| Entity Type | Individual |
| Full Name | MR. STACEY WARREN BERRY |
| Credential | APRN |
| Practice Address |
880 82nd Dr Gladstone OR 97027-1803 |
| Mailing Address |
Po Box 82819 Portland OR 97282-0819 |
| Practice Telephone | 5032728031 |
| Mailing Telephone | 5032335405 |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2020-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | S.160241 | OH | Behavioral Health & Social Service Providers |
| N | 163W00000X | Registered Nurse | RN.458469 | OH | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
202007113NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528215571 | Stacey Maxwell Berry | Specialist | 101 E Ross Ave, Sapulpa, OK 74066-6425 | 2008-08-21 |
| 1235681255 | Stacey Caitlynn Berry | Technician, Other | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2016-10-25 |
| 1447656731 | Stacey Lynn Berry | Social Worker | 940 Belmont St, Brockton, MA 02301 | 2014-11-13 |
| 1518369958 | Stacey M Berry | Psychologist | 2801 N Gantenbein Ave, Portland, OR 97227 | 2014-09-17 |
| 1487672796 | Stacey Elaine Berry | Nurse Practitioner | 1061 Harmon Ave, Ste. 1d03, Ft Stewart, GA 31314 | 2006-07-17 |
| 1336190313 | Stacey A Berry | Pathology | 801 7th Ave, Fort Worth, TX 76104-2733 | 2006-05-13 |
| Street Address |
880 82ND DR |
| City | GLADSTONE |
| State | OR |
| Zip Code | 97027-1803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497859888 | William Arthur Blakey Sr. | Psychologist | 880 82nd Dr, Gladstone, OR 97027-1803 | 2006-09-07 |
| 1952929960 | Kayla Dawn Carrar | Counselor | 880 82nd Dr, Gladstone, OR 97027-1803 | 2020-07-07 |
| 1245852417 | Mikaylee Dato | Counselor | 880 82nd Dr, Gladstone, OR 97027-1803 | 2020-05-11 |
| 1780204164 | Gennady Fortuna | Counselor | 880 82nd Dr, Gladstone, OR 97027-1803 | 2020-04-25 |
| 1720631609 | Grant William Cunningham | Counselor | 880 82nd Dr, Gladstone, OR 97027-1803 | 2019-07-19 |
| 1962983403 | Jessica Ann Holcomb | Psychologist | 880 82nd Dr, Gladstone, OR 97027-1803 | 2018-08-23 |
| 1982185500 | Jill Denise Henion | Marriage & Family Therapist | 880 82nd Dr, Gladstone, OR 97027-1803 | 2018-08-22 |
| 1194254359 | Naime Nansen Conrad | Student in an Organized Health Care Education/Training Program | 880 82nd Dr, Gladstone, OR 97027-1803 | 2017-06-09 |
| 1962946020 | Heather Rebecca Whitney | Social Worker | 880 82nd Dr, Gladstone, OR 97027-1803 | 2016-12-08 |
| 1154779403 | Cherie Thompson | Counselor | 880 82nd Dr, Gladstone, OR 97027-1803 | 2016-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484270 | Patricia Ann Combs | Massage Therapist | 255 E. Dartmouth St., Gladstone, OR 97027 | 2020-07-09 |
| 1376036764 | Gladstone Smiles Dentistry PC | Dentist | 20140 Mcloughlin Blvd, Gladstone, OR 97027 | 2018-06-11 |
| 1194111344 | Kacey Danyelle Dahmen | Behavioral Analyst | 890 Se 82nd Drive, Gladstone, OR 97027 | 2015-04-14 |
| 1255738092 | Western Psychological and Counseling Services PC | Community/Behavioral Health | 870 Se 82nd, Gladstone, OR 97027 | 2014-11-21 |
| 1548678097 | James Lee Briscoe | Counselor | 870 Se 82nd Dr., Bldg. C, Gladstone, OR 97027 | 2014-07-29 |
| 1003164690 | Chloe Elizabeth Lee-zorn | Psychologist | 890 Se 82nd, Gladstone, OR 97027 | 2012-08-29 |
| 1700187408 | Leonard Cogan | Counselor | 887 82nd Dr, Bldg C, Gladstone, OR 97027 | 2010-11-11 |
| 1851525620 | Sarah Morgan Schrauben | Psychiatry & Neurology | 870 Se 82nd Ave., Portland, OR 97027 | 2009-05-08 |
| 1093971640 | Western Psychological and Counseling Services PC | Counselor | 9670 Sw Beaverton-hillsdale Hwy, Beaverton, OR 97027 | 2008-08-04 |
| 1578606935 | Myron John Welbes | Counselor | 17663 Se 82nd Drive, Gladstone, OR 97027 | 2007-02-15 |
| Find all providers in zip 97027 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518062116 | Nancy Spence Lillie | Nurse Practitioner | 135 W Gloucester St, Gladstone, OR 97027-2032 | 2006-09-14 |
| 1538260781 | Maureen F Anderson | Nurse Practitioner | 305 Nw Englewood Court, Suite #300, Gladstone, MO 64118-4072 | 2006-09-26 |
| 1356454490 | Patricia K Mccoy | Nurse Practitioner | 305 Nw Englewood Ct, Suite 300, Gladstone, MO 64118-4072 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1629687892 | Robin Sue Finney | Nurse Practitioner | 1957 Thompson Rd Ste I, Coos Bay, OR 97420-2040 | 2020-07-23 |
| 1518584457 | Akhena Health & Wellness LLC | Nurse Practitioner | 8855 Sw Holly Ln Ste 129, Wilsonville, OR 97070-8793 | 2020-06-26 |
| 1447871678 | Monarch Mental Health LLC | Nurse Practitioner | 1927 Channel St, North Bend, OR 97459-1826 | 2020-04-28 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1366071607 | Med Rx Partners, P.C. | Nurse Practitioner | 12115 Sw 70th Ave Ste 202, Tigard, OR 97223-9648 | 2020-04-08 |
| 1417583170 | Brittany Joy Monson | Nurse Practitioner | 12115 Sw 70th Ave, Tigard, OR 97223-9647 | 2020-03-13 |
| 1073147716 | Paradigm Mental Health and Wellness LLC | Nurse Practitioner | 724 S Central Ave Ste 101d, Medford, OR 97501-7808 | 2020-03-02 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.