Provider Demographics
NPI:1750430690
Name:SCHAEFER, STEPHANIE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MARIE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 NW FLANDERS ST # 143
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2645
Mailing Address - Country:US
Mailing Address - Phone:503-836-3152
Mailing Address - Fax:503-836-3155
Practice Address - Street 1:1336 NW FLANDERS ST # 143
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2645
Practice Address - Country:US
Practice Address - Phone:503-836-3152
Practice Address - Fax:503-836-3155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2396103TC0700X
171M00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)