Provider Demographics
NPI:1841379112
Name:RAYMOND, STACY ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:ANN
Last Name:RAYMOND
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 1:100B DANBURY RD, SUITE 101
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4110
Mailing Address - Country:US
Mailing Address - Phone:203-493-0344
Mailing Address - Fax:203-438-6223
Practice Address - Street 1:100B DANBURY RD, SUITE 101
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4110
Practice Address - Country:US
Practice Address - Phone:203-493-0344
Practice Address - Fax:203-438-6223
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1974103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical