Provider Demographics
NPI:1306353131
Name:STONE, MATTHEW DANIEL (LMSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DANIEL
Last Name:STONE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2619
Mailing Address - Country:US
Mailing Address - Phone:734-682-5544
Mailing Address - Fax:
Practice Address - Street 1:127 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2619
Practice Address - Country:US
Practice Address - Phone:734-682-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801114697104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker