Provider Demographics
NPI:1679219430
Name:STONE, MORGAN LEE (CADC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEE
Last Name:STONE
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 S HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8055
Mailing Address - Country:US
Mailing Address - Phone:515-232-5811
Mailing Address - Fax:
Practice Address - Street 1:1619 S HIGH AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8055
Practice Address - Country:US
Practice Address - Phone:515-232-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22001101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA22001OtherIOWA BOARD OF CERTIFICATION