Provider Demographics
NPI:1518137454
Name:STONE, KELLY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N PALAFOX ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-2664
Mailing Address - Country:US
Mailing Address - Phone:850-266-2700
Mailing Address - Fax:850-595-0179
Practice Address - Street 1:1300 N PALAFOX ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2664
Practice Address - Country:US
Practice Address - Phone:850-266-2700
Practice Address - Fax:850-595-0179
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002998101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional