Stack, Deborah Jean
Stack, Deborah Jean is an individual health care provider with primary practice located at 682 Prospect Avenue , Hartford CT 06105. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Stack, Deborah Jean can be contacted via phone (860) 258-6065.Contact Information
Primary practice address
682 Prospect Avenue
Hartford CT 06105
Phone: (860) 258-6065
Fax: (860) 232-5077
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1238 | Connecticut |
Profile Details
| NPI number | 1023195864 |
|---|---|
| LBN Legal business name | Stack, Deborah Jean |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023195864 | NPPES |
| Connecticut | Other | 060001238CT01 | BCBS |
| Connecticut | Other | HAS394 | BCBS |
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