Provider Demographics
NPI:1033174602
Name:STONE, MICHAEL A (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:STONE
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 W HAVENS STREET
Mailing Address - Street 2:DAKOTA COUNSELING INSTITUTE
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301
Mailing Address - Country:US
Mailing Address - Phone:605-996-9686
Mailing Address - Fax:605-996-1624
Practice Address - Street 1:910 W HAVENS STREET
Practice Address - Street 2:DAKOTA COUNSELING INSTITUTE
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301
Practice Address - Country:US
Practice Address - Phone:605-996-9686
Practice Address - Fax:605-996-1624
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD453103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD39219OtherSIOUX VALLEY HEALTH
SD4873OtherAVERA HEALTH
SD4995128OtherWELLMARK BC/BS
SD9209686OtherDAKOTACARE
SD9209686OtherDAKOTACARE