Provider Demographics
NPI:1891235966
Name:STONE, REBECCA LYNN (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PRIMERA BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2168
Mailing Address - Country:US
Mailing Address - Phone:407-358-6599
Mailing Address - Fax:321-558-7300
Practice Address - Street 1:255 PRIMERA BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2168
Practice Address - Country:US
Practice Address - Phone:407-358-6599
Practice Address - Fax:321-558-7300
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health