Berry, Stacey M

Berry, Stacey M is an individual health care provider with primary practice located at 2801 N Gantenbein Ave , Portland OR 97227. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Berry, Stacey M can be contacted via phone (503) 276-8785.

Contact Information

Primary practice address
2801 N Gantenbein Ave Portland OR 97227
Phone: (503) 276-8785
Fax: (503) 276-9241
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2014033259 Missouri
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2993 Oregon

Profile Details

NPI number 1518369958
LBN Legal business name Berry, Stacey M
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2014
Last updated Aug 15th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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