Organization
STONE THERAPY AND CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EZRA LAVENDER STONE LCSW (CLINICIAN OWNER)
(386) 316-6948
Entity
Organization
Contact information
Practice address
3131 NW 13TH ST, GAINESVILLE, FL 32609-5902
(386) 316-6948
Mailing address
1842 NE 167TH PL, GAINESVILLE, FL 32609-4515
(386) 316-6948
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356806814
INDIVIDUAL NPI NUMBER
—
Enumeration date
09/20/2022
Last updated
09/20/2022
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