Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacy Ann Wilson, CRM, QMHA, CADC

Individual provider Specialist · NPI 1386277150

Stacy Ann Wilson, CRM, QMHA, CADC is a Specialist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2020.

Licensed in
OR
In the registry since
2020
Specialties on file
3
What do these letters mean?
CADC — Certified Alcohol and Drug Counselor
A certified addiction counsellor.

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Practice location Address checks out

2901 E Burnside St
Portland, OR 97214-1831
Phone: (503) 238-5203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 25-03-11415 (OR)
Specialist Taxonomy 174400000X · Licence 24-QMHA-I-004213 (OR)
Peer Specialist Taxonomy 175T00000X · Licence 20-CRM-007 (OR)

Record details

NPI number1386277150
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRM , QMHA , CADC
Sole proprietorNo
NPI enumeratedFebruary 19, 2020
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

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