STACEY GORDON CONNELLY (OTRL CHT) – Occupational Therapist, NPI 1174580872

STACEY GORDON CONNELLY (OTRL CHT) is a healthcare provider. based in Providence, Rhode Island. specializing in Occupational Therapist. They hold the professional credentials OTRL CHT. They hold a License No. OT00892 (RI). The NPI Number for STACEY GORDON CONNELLY (OTRL CHT) is 1174580872

Main info

Female
Name
STACEY GORDON CONNELLY (OTRL CHT)
NPI
1174580872
Phone
(401) 861-2976
Address
424 RIVER AVE
Enumeration Date
27 April 2006
Last Update Date
8 July 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for STACEY GORDON CONNELLY (OTRL CHT)

  • 424, River Avenue, Providence, Providence County, Rhode Island, 02908, United States

    PROVIDENCE, RI 029083438

    Phone: (401) 861-2976

    Type: Mailing

  • Miriam Hospital, 164, Summit Avenue, Providence, Providence County, Rhode Island, 02906, United States

    PROVIDENCE, RI 029062853

    Phone: (401) 793-2500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02908)

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Frequently asked questions

How is STACEY GORDON CONNELLY (OTRL CHT) identified in CMS data?
CMS-hosted NPPES data lists STACEY GORDON CONNELLY (OTRL CHT) with NPI 1174580872.
Can I rely on STACEY GORDON CONNELLY (OTRL CHT) being an active provider?
As of the registry snapshot, STACEY GORDON CONNELLY (OTRL CHT) is marked active.
What is STACEY GORDON CONNELLY (OTRL CHT)'s specialty?
The listing groups STACEY GORDON CONNELLY (OTRL CHT) with Occupational Therapist. Clinical services aligned with this taxonomy classification.
What area does STACEY GORDON CONNELLY (OTRL CHT) serve?
STACEY GORDON CONNELLY (OTRL CHT)'s listing highlights Providence, Rhode Island; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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