Provider Demographics
NPI:1811990294
Name:STONE, SUE CAROL (MA)
Entity type:Individual
Prefix:MS
First Name:SUE
Middle Name:CAROL
Last Name:STONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 NORTHVIEW ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5102
Mailing Address - Country:US
Mailing Address - Phone:865-588-3511
Mailing Address - Fax:865-588-2486
Practice Address - Street 1:105 NORTHVIEW ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5102
Practice Address - Country:US
Practice Address - Phone:865-588-3511
Practice Address - Fax:865-588-2486
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0111231H00000X, 231HA2500X, 2355S0801X, 237600000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN31921462OtherMEDICARE PTAN
TN4117082OtherBCBS TN (C. P. S.)
TN0488329OtherCIGNA HEALTHCARE