Provider Demographics
NPI:1740715176
Name:STONER, KELSEY (LSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:STONER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 COUNTY ROAD 58
Mailing Address - Street 2:
Mailing Address - City:KANSAS
Mailing Address - State:OH
Mailing Address - Zip Code:44841-9620
Mailing Address - Country:US
Mailing Address - Phone:567-280-2887
Mailing Address - Fax:
Practice Address - Street 1:206 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4914
Practice Address - Country:US
Practice Address - Phone:419-340-0972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OHS.1501144104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)