MEDICARE: STACY J NIELSEN, LCSW, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	L6376	OR

General Provider Information

NPI Number	:	1861843310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STACY J NIELSEN, LCSW, LLC

Provider Business Mailing Address
First Line	:	11 SW BRANTLEY DR
Second Line	:
City	:	WINSTON
State	:	OR
Zip	:	97496
Country	:	US
Telephone Number	:	541-679-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 SW BRANTLEY DR
Second Line	:
City	:	WINSTON
State	:	OR
Zip	:	97496-4526
Country	:	US
Telephone Number	:	541-679-0366
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STACY JEAN NIELSEN
Credential	:	LCSW
Telephone Number	:	541-802-6597

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	06/27/2016

Similar Medicare Providers

1033462866 — KATHRYN VARA RN
Practice Location Address:

77 SW BRANTLEY DR
WINSTON, OR
97496-4526

Practice Phone: 541-671-7885
Practice Fax:

1316286719 — RABECCA MARIE STEELE LPN
Practice Location Address:

77 SW BRANTLEY DR
WINSTON, OR
97496-4526

Practice Phone: 541-680-0179
Practice Fax:

1154788065 — MR. MICHAEL WAYNE SMITH- FERNANDEZ LCSW
Practice Location Address:

11 SW BRANTLEY DR
WINSTON, OR
97496-4526

Practice Phone: 541-679-0366
Practice Fax: 541-679-4821

1881052876 — MS. LISA MARIE JENNINGS MSW,QMHP, CSWA, CADC
Practice Location Address:

11 SW BRANTLEY DR
WINSTON, OR
97496-4526

Practice Phone: 541-679-0366
Practice Fax: 541-679-4821

1154944536 — FUNCTIONAL MENTAL HEALTH LLC
Practice Location Address:

11 SW BRANTLEY DR
WINSTON, OR
97496-4526

Practice Phone: 541-679-0366
Practice Fax: 541-679-4821

1669117321 — ANN CAREY
Practice Location Address:

11 SW BRANTLEY DR
WINSTON, OR
97496-4526

Practice Phone: 541-679-0366
Practice Fax: 541-679-4821

Directions to “STACY J NIELSEN, LCSW, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.