Individual provider · Type 1 NPI

Stacy Ann Wilson, CRM, QMHA, CADC

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1386277150 Active

Practice location

2901 E Burnside St
Portland, OR 97214-1831

Call (503) 238-5203 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist 174400000X24-QMHA-I-004213 (OR)
Peer Specialist 175T00000X20-CRM-007 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X25-03-11415 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1386277150

Stacy Ann Wilson, CRM, QMHA, CADC's National Provider Identifier is 1386277150, issued on Feb 19, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Mar 4, 2025.