Provider Demographics
NPI:1093080665
Name:STONE, MARIE F (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:F
Last Name:STONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-1905
Mailing Address - Country:US
Mailing Address - Phone:860-608-0386
Mailing Address - Fax:860-887-2784
Practice Address - Street 1:29 EAGLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-1905
Practice Address - Country:US
Practice Address - Phone:860-608-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional