Provider Demographics
NPI:1366245243
Name:REICH, STACEY E (LCSW)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:E
Last Name:REICH
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2836
Mailing Address - Country:US
Mailing Address - Phone:201-525-0607
Mailing Address - Fax:201-525-0608
Practice Address - Street 1:241 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2836
Practice Address - Country:US
Practice Address - Phone:201-525-0607
Practice Address - Fax:201-525-0608
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0146900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health