Provider Demographics
NPI:1326547431
Name:STONEY, GERTRUDE ELIZABETH (LISW-CP)
Entity Type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:ELIZABETH
Last Name:STONEY
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-1927
Mailing Address - Country:US
Mailing Address - Phone:803-549-1921
Mailing Address - Fax:
Practice Address - Street 1:518 SADDLE DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-1927
Practice Address - Country:US
Practice Address - Phone:803-549-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical