Provider Demographics
NPI:1649390030
Name:STONE, MATTHEW MARLER (MSSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:MARLER
Last Name:STONE
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 RAPHAEL AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-1310
Mailing Address - Country:US
Mailing Address - Phone:978-349-8580
Mailing Address - Fax:
Practice Address - Street 1:131 RAPHAEL AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-1310
Practice Address - Country:US
Practice Address - Phone:978-349-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor