Provider Demographics
NPI:1114768488
Name:STONER FEHSENFELD, DAVID MATTHEW (LMFT-IT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MATTHEW
Last Name:STONER FEHSENFELD
Suffix:
Gender:M
Credentials:LMFT-IT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:MATTHEW
Other - Last Name:STONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 FORWARD DRIVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2443
Mailing Address - Country:US
Mailing Address - Phone:608-268-6530
Mailing Address - Fax:608-709-1744
Practice Address - Street 1:815 FORWARD DRIVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2443
Practice Address - Country:US
Practice Address - Phone:608-268-6530
Practice Address - Fax:608-709-1744
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist