Provider Demographics
NPI:1497772917
Name:SCHACHER, STEPHANIE JILL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JILL
Last Name:SCHACHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:JILL
Other - Last Name:SCHACHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:123 SAXONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-2362
Mailing Address - Country:US
Mailing Address - Phone:203-292-9845
Mailing Address - Fax:203-292-9845
Practice Address - Street 1:21 RICE TER
Practice Address - Street 2:SUITE 313
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3853
Practice Address - Country:US
Practice Address - Phone:203-292-9845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015115103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02660497Medicaid
P83918Medicare UPIN
NY02660497Medicaid