Provider Demographics
NPI:1922850981
Name:STONE, VIRGIE JADE (LMHC)
Entity Type:Individual
Prefix:
First Name:VIRGIE
Middle Name:JADE
Last Name:STONE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 NORMANDY BLVD APT 212
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-7661
Mailing Address - Country:US
Mailing Address - Phone:904-982-5666
Mailing Address - Fax:
Practice Address - Street 1:5960 BEACH BLVD STE 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5113
Practice Address - Country:US
Practice Address - Phone:904-701-0229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health