Healthcare Provider Details

I. General information

NPI: 1154780336
Provider Name (Legal Business Name): STACEY HOPKINS REICHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 FARMINGTON AVE FL 2
FARMINGTON CT
06032-1901
US

IV. Provider business mailing address

89 MEADOW LN
WEST HARTFORD CT
06107-1516
US

V. Phone/Fax

Practice location:
  • Phone: 860-837-6736
  • Fax: 860-837-6765
Mailing address:
  • Phone: 860-313-0682
  • Fax: 860-837-6736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004879
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: