Provider Demographics
NPI:1154362226
Name:STONE, TINA B (MSW)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:B
Last Name:STONE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3443
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66063-3443
Mailing Address - Country:US
Mailing Address - Phone:913-707-3240
Mailing Address - Fax:
Practice Address - Street 1:751 E 63RD ST STE 212
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3372
Practice Address - Country:US
Practice Address - Phone:913-707-3240
Practice Address - Fax:816-281-9622
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2022-10-11
Deactivation Date:2022-08-23
Deactivation Code:
Reactivation Date:2022-10-11
Provider Licenses
StateLicense IDTaxonomies
KS11221041C0700X
MO0049881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO496033119Medicaid