Provider Demographics
NPI:1326362252
Name:STONE, BOBBI JO (LMSW)
Entity Type:Individual
Prefix:
First Name:BOBBI JO
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:LMSW
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 84
Mailing Address - Street 2:
Mailing Address - City:DOWNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13755-0084
Mailing Address - Country:US
Mailing Address - Phone:607-220-7876
Mailing Address - Fax:
Practice Address - Street 1:576 KNOX AVE
Practice Address - Street 2:
Practice Address - City:DOWNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13755-0927
Practice Address - Country:US
Practice Address - Phone:607-220-7876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075147-1101YM0800X
MI68010914321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical