Provider Demographics
NPI:1528390523
Name:STONE, DANIEL JOEL
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOEL
Last Name:STONE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW,LISAC
Mailing Address - Street 1:4949 E PLACITA ALISA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4634
Mailing Address - Country:US
Mailing Address - Phone:520-403-4114
Mailing Address - Fax:520-615-6479
Practice Address - Street 1:4949 E PLACITA ALISA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-4634
Practice Address - Country:US
Practice Address - Phone:520-403-4114
Practice Address - Fax:520-615-6479
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC 0968101YA0400X
AZLCSW 24791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)