Individual
STACEY DEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 HOPE ST, PROVIDENCE, RI 02906-2001
(401) 228-4115
Mailing address
15 BRIARWOOD DR, QUAKER HILL, CT 06375-1002
(401) 228-4115
(401) 228-4115
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/12/2026
Last updated
02/16/2026
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