Provider Demographics
NPI:1861643231
Name:STONE, JAMES BUFORD (LCSW, ICCDP-D)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BUFORD
Last Name:STONE
Suffix:
Gender:M
Credentials:LCSW, ICCDP-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 PARADOR BND
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-9058
Mailing Address - Country:US
Mailing Address - Phone:404-754-6188
Mailing Address - Fax:770-914-1925
Practice Address - Street 1:455 WINN WAY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1707
Practice Address - Country:US
Practice Address - Phone:404-508-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0045891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical