Provider Demographics
NPI:1225374739
Name:GRACE-STONE, NICHOLAS (MSW)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:GRACE-STONE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 PALOMAS DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1625
Mailing Address - Country:US
Mailing Address - Phone:505-550-1539
Mailing Address - Fax:
Practice Address - Street 1:1601 RANDOLPH RD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4276
Practice Address - Country:US
Practice Address - Phone:505-550-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator