Provider Demographics
NPI:1093421034
Name:STONE, JENNA (LMSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1112
Mailing Address - Country:US
Mailing Address - Phone:716-465-1988
Mailing Address - Fax:
Practice Address - Street 1:41 TYLER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1112
Practice Address - Country:US
Practice Address - Phone:716-465-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104265104100000X
NY111438104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker