Provider Demographics
NPI:1285670976
Name:STONE, GENE F (MA)
Entity Type:Individual
Prefix:MR
First Name:GENE
Middle Name:F
Last Name:STONE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1022
Mailing Address - Street 2:
Mailing Address - City:MILLERS CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:28651-1022
Mailing Address - Country:US
Mailing Address - Phone:336-973-7998
Mailing Address - Fax:336-973-7998
Practice Address - Street 1:403 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2505
Practice Address - Country:US
Practice Address - Phone:336-984-1697
Practice Address - Fax:336-984-1697
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102463Medicaid