Provider Demographics
NPI:1942772116
Name:STONIER, MADALENE (LCSW)
Entity Type:Individual
Prefix:
First Name:MADALENE
Middle Name:
Last Name:STONIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MADI
Other - Middle Name:
Other - Last Name:STONIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5140 PARK RIM DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-1044
Mailing Address - Country:US
Mailing Address - Phone:858-382-0323
Mailing Address - Fax:
Practice Address - Street 1:2635 CAMINO DEL RIO S STE 211
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3729
Practice Address - Country:US
Practice Address - Phone:858-382-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA761881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical