Individual
BENJAMIN MATTHIAS STONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, BCBA
Contact information
Practice address
3760 LAVISTA RD, TUCKER, GA 30084-5615
(678) 626-0557
Mailing address
3756 LAVISTA RD, TUCKER, GA 30084-5614
(678) 617-0871
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC013227
GA
103K00000X
Behavior Analyst
Primary
1-23-67146
GA
Other
Enumeration date
05/10/2021
Last updated
08/02/2023
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