Basic Information
| Provider Information | |||||||||
| NPI: | 1326416835 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STONE | ||||||||
| FirstName: | BRANDI | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2910 EAST FRANKLIN BLVD #1 | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046480460 | ||||||||
| FaxNumber: | 8554467146 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 N TRYON ST STE 1610 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282020202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882318880 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2015 | ||||||||
| LastUpdateDate: | 05/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 103983 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | C011143 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.