Stacey Ricca, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58.010064 Issued in CT

Practice address

50 Gaylord Farm Rd
Wallingford, CT 06492-2899

Phone

(203) 284-2820

NPI assigned

Feb 19, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacey Rahl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1376009027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GAYLORD FARM RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922899",
            "telephone_number": "203-284-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GAYLORD FARM RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922899",
            "telephone_number": "203-284-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCA",
        "first_name": "STACEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.010064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "RAHL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Reza Moien MD Internal Medicine LLC
• Nicholas Rezendes, D.P.T.
• Ludmila Reznik
• Rhoda L Kreisman PH D
• Yuliya Viktorovna Riat, M.D.
• Thomas Kenneth Richard Jr.
• Gretchen Elizabeth Richardson, LCSW
• Kristina Ridnert, P.T.
• Rania Rifaey, MD
• Erin Elizabeth Riley

• Clinical Social Worker in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.