Organization
WHITE STONE PSYCHIATRIC SERVICES
Active
Other names
White Stone Psychiatric Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY CARPENTER MD (OWNER)
(513) 673-6740
Entity
Organization
Contact information
Practice address
5108 SANDY LN, FAIRFIELD, OH 45014-2738
(513) 234-5959
Mailing address
5108 SANDY LN, FAIRFIELD, OH 45014-2738
(513) 234-5959
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156279
—
OH
Enumeration date
01/13/2016
Last updated
05/11/2016
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