Basic Information
| Provider Information | |||||||||
| NPI: | 1346881281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STONE | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | LOUIS | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | LMHC, LCAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 TYLER AVE | ||||||||
| Address2: | |||||||||
| City: | MILLER PLACE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117643129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082689974 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 90 ADAMS AVE | ||||||||
| Address2: | |||||||||
| City: | HAUPPAUGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117883631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6319523333 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2019 | ||||||||
| LastUpdateDate: | 10/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 008326 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 221700000X | 002175 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist |
No ID Information.