Provider Demographics
NPI:1033832605
Name:STONE THERAPY AND CONSULTING, LLC
Entity Type:Organization
Organization Name:STONE THERAPY AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EZRA
Authorized Official - Middle Name:LAVENDER
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:386-316-6948
Mailing Address - Street 1:1842 NE 167TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-4515
Mailing Address - Country:US
Mailing Address - Phone:386-316-6948
Mailing Address - Fax:
Practice Address - Street 1:3131 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-5902
Practice Address - Country:US
Practice Address - Phone:386-316-6948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356806814OtherINDIVIDUAL NPI NUMBER