National Provider Identifier Database

SHANEEN D STACER, PHD – NPI #1427485440
Clinical

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.


Contact Information

SHANEEN D STACER, PHD
1900 WOODLAND DR
COOS BAY, OR97420-2045
Phone: 541-267-5151
Fax: 541-266-4554
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X
Addiction (Substance Use Disorder) 103TA0400X
Clinical Child & Adolescent 103TC2200X
Cognitive & Behavioral 103TB0200X
Group Psychotherapy 103TP2701X
Health 103TH0004X
Health Service 103TH0100X
Psychologist 103T00000X

* Indicates primary specialty

NPI Profile & details for SHANEEN D STACER

NPI Number 1427485440
Credentials PHD
Entity Individual
Enumeration date 10/04/2013
Last updated 09/08/2016 - About 10 years ago
Sole proprietor1 No
Identifiers
  • OR License #: 2500
  • WI License #: 3079-57
  • OR Medicaid: 500684206
  • OR Other: 161133 NORTH BEND MEDICAL CENTER GROUP MEDICAID
  • OR Other: R0000WFBTV NORTH BEND MEDICAL CENTER GROUP MEDICARE
  • OR Other: 1407812365 NORTH BEND MEDICAL CENTER GROUP NPI
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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