Provider Demographics
NPI: | 1821786716 |
---|---|
Name: | MELISSA STONE COUNSELING AND CONSULTING, LLC |
Entity Type: | Organization |
Organization Name: | MELISSA STONE COUNSELING AND CONSULTING, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MELISSA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | STONE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCSW |
Authorized Official - Phone: | 812-727-4577 |
Mailing Address - Street 1: | 101 W KIRKWOOD AVE STE 249 |
Mailing Address - Street 2: | |
Mailing Address - City: | BLOOMINGTON |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 47404-0004 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 812-727-4577 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 101 W KIRKWOOD AVE STE 249 |
Practice Address - Street 2: | |
Practice Address - City: | BLOOMINGTON |
Practice Address - State: | IN |
Practice Address - Zip Code: | 47404-0004 |
Practice Address - Country: | US |
Practice Address - Phone: | 812-727-4577 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-04-27 |
Last Update Date: | 2023-04-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Single Specialty |