Basic Information
| Provider Information | |||||||||
| NPI: | 1154780336 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REICHER | ||||||||
| FirstName: | STACEY | ||||||||
| MiddleName: | HOPKINS | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 89 MEADOW LN | ||||||||
| Address2: | |||||||||
| City: | WEST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061071516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603130682 | ||||||||
| FaxNumber: | 8608376736 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 FARMINGTON AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060321901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608376736 | ||||||||
| FaxNumber: | 8608376765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2016 | ||||||||
| LastUpdateDate: | 02/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 004879 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.