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:
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Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023195864 NPPES
Connecticut Other 060001238CT01 BCBS
Connecticut Other HAS394 BCBS

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