Provider Demographics
NPI:1851838049
Name:STONE, REBECCA (PHD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W END AVE
Mailing Address - Street 2:SUITE 1S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6103
Mailing Address - Country:US
Mailing Address - Phone:917-670-2553
Mailing Address - Fax:
Practice Address - Street 1:142 W END AVE
Practice Address - Street 2:SUITE 1S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6103
Practice Address - Country:US
Practice Address - Phone:917-670-2553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68021705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical