Provider Demographics
NPI:1770925778
Name:ARONSON, STACEY ROSENKRANTZ (PHD)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:ROSENKRANTZ
Last Name:ARONSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 POST RD W
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4626
Mailing Address - Country:US
Mailing Address - Phone:203-454-5555
Mailing Address - Fax:
Practice Address - Street 1:181 POST RD W
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4626
Practice Address - Country:US
Practice Address - Phone:203-247-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68 020026103G00000X, 103TC0700X
CT003302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical