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Organization
THERAPY STUDIO
Active
Organization
THERAPY STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY STONE LCPC (OWNER)
(708) 906-5246
Entity
Organization
Contact information
Practice address
295 W DIVISION ST, COAL CITY, IL 60416-1581
(815) 515-0010
(708) 590-0759
Mailing address
295 W DIVISION ST, COAL CITY, IL 60416-1581
(815) 515-0010
(708) 590-0759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
102L00000X
Psychoanalyst
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164805297
NPI
—
Enumeration date
11/15/2019
Last updated
01/29/2020
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