Individual
DR. STACY BURDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DM- BCC (2054) RBAI
Contact information
Practice address
1230 WESTWOOD DR NW, SALEM, OR 97304-3749
(971) 208-4663
Mailing address
1230 WESTWOOD DR NW, SALEM, OR 97304-3749
(971) 208-4663
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
Primary
—
OR
106S00000X
Behavior Technician
ABA-IN-10254263
OR
374K00000X
Religious Nonmedical Practitioner
2054
FL
390200000X
Student in an Organized Health Care Education/Training Program
ABA-IN-10254263
OR
Other
Enumeration date
01/23/2023
Last updated
07/20/2026
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