Provider Demographics
NPI:1023395084
Name:STAGES COUNSELING LLC
Entity Type:Organization
Organization Name:STAGES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:STEPHANIE
Authorized Official - Last Name:STANDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-581-0657
Mailing Address - Street 1:2659 COMMERCIAL ST SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4496
Mailing Address - Country:US
Mailing Address - Phone:503-581-0657
Mailing Address - Fax:503-581-4025
Practice Address - Street 1:2659 COMMERCIAL ST SE.
Practice Address - Street 2:SUITE 200
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4496
Practice Address - Country:US
Practice Address - Phone:503-581-0657
Practice Address - Fax:503-581-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL3040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR132768Medicare UPIN