Provider Demographics
NPI:1942438429
Name:STONE, GEORGE PATRICK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:PATRICK
Last Name:STONE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 BROOK HILL CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-1967
Mailing Address - Country:US
Mailing Address - Phone:907-350-2497
Mailing Address - Fax:
Practice Address - Street 1:2548 BROOK HILL CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-1967
Practice Address - Country:US
Practice Address - Phone:907-350-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK75-3149780Medicaid