Provider Demographics
NPI:1457463754
Name:STONE, DEBRA ANN (MSN, LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:STONE
Suffix:
Gender:F
Credentials:MSN, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-4337
Mailing Address - Country:US
Mailing Address - Phone:918-760-8116
Mailing Address - Fax:918-492-3542
Practice Address - Street 1:2990 N SIOUX AVE
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3700
Practice Address - Country:US
Practice Address - Phone:918-342-2622
Practice Address - Fax:918-342-2641
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14331041C0700X
OKR0081435390200000X
OK81435364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program