Provider Demographics
NPI:1578772216
Name:STONE, STEPHEN SCOTT (MSW, LISW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:SCOTT
Last Name:STONE
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8623
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87504-8623
Mailing Address - Country:US
Mailing Address - Phone:505-983-7616
Mailing Address - Fax:
Practice Address - Street 1:1435 S SAINT FRANCIS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4202
Practice Address - Country:US
Practice Address - Phone:505-795-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-053371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical