Provider Demographics
NPI:1245734862
Name:STONE, ROBIN D
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 135TH ST APT 2N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2757
Mailing Address - Country:US
Mailing Address - Phone:917-374-2149
Mailing Address - Fax:
Practice Address - Street 1:96 W HOUSTON ST STE 1R&1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2553
Practice Address - Country:US
Practice Address - Phone:917-746-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP06362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health