Provider Demographics
NPI:1124055660
Name:STONER, KATHRYN C (MSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:C
Last Name:STONER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:P
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1229 C AVENUE EAST
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577
Mailing Address - Country:US
Mailing Address - Phone:641-672-3159
Mailing Address - Fax:641-672-3259
Practice Address - Street 1:1229 C AVENUE EAST
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577
Practice Address - Country:US
Practice Address - Phone:641-672-3159
Practice Address - Fax:641-672-3259
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
43843OtherWELLMARK BLUE CROSS
42105384450265-1021OtherTRIWEST
43843OtherBCBS
IA0014316Medicaid
234908OtherMIDLANDS CHOICE
43843OtherWELLMARK BLUE CROSS
IA0014316Medicaid