Provider Demographics
NPI:1376134734
Name:DAVIS, STACY FAYE (CADC-R)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:FAYE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 CENTENNIAL LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7900
Mailing Address - Country:US
Mailing Address - Phone:541-393-0777
Mailing Address - Fax:541-687-9279
Practice Address - Street 1:78 CENTENNIAL LOOP STE A
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7900
Practice Address - Country:US
Practice Address - Phone:541-393-0777
Practice Address - Fax:541-687-9279
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)