Individual ProviderStacey RacePsychologistBehavioral Health & Social Service ProvidersPractice Address41347 Raspberry Drive, Leesburg, VA 20176(703) 975-9794PECOS EnrollmentBased on the most recent information from CMS, provider Stacey Race does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1942507611Provider TypeIndividualFull NameRace, StaceyTitleDr.CredentialPSY, D.GenderFemaleSole ProprietorYesEnumeration Date2/16/2011Last Updated2/16/2011Contact InformationPractice LocationPractice Address41347 Raspberry Drive, Leesburg, VA 20176Phone(703) 975-9794Fax(703) 737-3922Mailing LocationMailing Address41347 Raspberry Drive, Leesburg, VA 20176Phone(703) 975-9794Fax(703) 737-3922Provider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense0810004121Virginia