Provider Demographics
NPI:1326448135
Name:STONE, NICHOLE
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:
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 1:41 MASON ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2265
Mailing Address - Country:US
Mailing Address - Phone:978-745-2240
Mailing Address - Fax:978-744-1701
Practice Address - Street 1:29 PINE ST # 1
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2029
Practice Address - Country:US
Practice Address - Phone:605-254-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker