Provider Demographics
NPI:1063524494
Name:STONE SCOTT, WENDY (PCC)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:STONE SCOTT
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:M
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PC
Mailing Address - Street 1:1437 LARCHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3401
Mailing Address - Country:US
Mailing Address - Phone:216-227-9647
Mailing Address - Fax:
Practice Address - Street 1:1005 ABBE RD N
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1613
Practice Address - Country:US
Practice Address - Phone:180-099-5522
Practice Address - Fax:440-365-6519
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0007643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0308483Medicaid