Provider Demographics
NPI:1225440977
Name:STELL, CAITLIN (PSYD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:STELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 POST RD E STE 494
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4540
Mailing Address - Country:US
Mailing Address - Phone:203-293-8493
Mailing Address - Fax:
Practice Address - Street 1:606 POST RD E STE 494
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4540
Practice Address - Country:US
Practice Address - Phone:203-293-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4014103TC0700X
COPSY.0005041103TC0700X
NY024277-01103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program