Provider Demographics
NPI:1124032669
Name:STONE, TRACY JEANETTE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:JEANETTE
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 1:2791 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15133-2017
Mailing Address - Country:US
Mailing Address - Phone:412-675-8855
Mailing Address - Fax:412-675-8860
Practice Address - Street 1:331 SHAW AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132
Practice Address - Country:US
Practice Address - Phone:412-675-8855
Practice Address - Fax:412-675-8860
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 003959101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA251207461005OtherTRICARE
PA1804159OtherHIGHMARK