Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Wallace Stacy Jr., LCSW

Individual provider Clinical Social Worker · NPI 1588190862

Mr. Wallace Stacy Jr., LCSW is a Clinical Social Worker in Wilton, Connecticut. Practices as a sole proprietor. Licensed in Connecticut.

Licensed in
CT
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

21 Richdale Dr Apt A
Wilton, CT 06897-2008
Phone: (914) 309-6442
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 007936 (CT)

Record details

NPI number1588190862
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 5, 2017
Last updated in NPPESMay 5, 2017

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