Grodd, Stacey

Grodd, Stacey is an sole proprietor health care provider with primary practice located at 264 Amity Rd , Woodbridge CT 06525-2200. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Grodd, Stacey can be contacted via phone (203) 397-0011.

Contact Information

Primary practice address
264 Amity Rd Woodbridge CT 06525-2200
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 003672 Connecticut

Profile Details

NPI number 1891968285
LBN Legal business name Grodd, Stacey
Credentials MSW,LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 8th, 2008
Last updated Apr 8th, 2008 - about 16 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 1891968285 NPPES
Connecticut Other 140003672CT01 ANTHEM BEHAVIORAL HEALTH

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