Healthcare Provider Details

I. General information

NPI: 1114124641
Provider Name (Legal Business Name): STEPHEN JOSEPH COMELLA LPC, MAC, CADC III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2713 CREIGHTON ST
WOODBURN OR
97071-4432
US

IV. Provider business mailing address

2713 CREIGHTON ST
WOODBURN OR
97071-4432
US

V. Phone/Fax

Practice location:
  • Phone: 971-983-5214
  • Fax:
Mailing address:
  • Phone: 971-472-5763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC2524
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: