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General NPI Number Information
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NPI Number | 1780546325
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Entity Type | Individual
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Provider Name | STEPHENIE WELLS CADC-R, QMHA-R, CRM
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1010 11TH AVE SW
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City | ALBANY
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State | OR
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Zip | 97321-2019
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Country | US
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Telephone | 541-791-7193
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 11TH AVE SW
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City | ALBANY
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State | OR
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Zip | 97321-2019
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Country | US
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Telephone | 541-791-7193
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 25-QMHA-R6466
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 25-CRM-4771
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | T-23-3309
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License Number State | OR
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