Provider Demographics
NPI:1639699838
Name:STONE, STEPHANIE (MSW, CAPSW, SAC-IT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MSW, CAPSW, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 123RD ST
Mailing Address - Street 2:APT 5G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5008
Mailing Address - Country:US
Mailing Address - Phone:608-620-5961
Mailing Address - Fax:
Practice Address - Street 1:680 W END AVE
Practice Address - Street 2:STE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6815
Practice Address - Country:US
Practice Address - Phone:608-620-5961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI90531231041C0700X
NY0881771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical