Provider Demographics
NPI:1588210165
Name:STONE, SAMANTHA KELLY (LMHCA)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:KELLY
Last Name:STONE
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S JACKSON ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2872
Mailing Address - Country:US
Mailing Address - Phone:805-423-5255
Mailing Address - Fax:
Practice Address - Street 1:108 S JACKSON ST STE 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2872
Practice Address - Country:US
Practice Address - Phone:805-423-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health