Provider Demographics
NPI:1316795933
Name:STONE, CASSIDY N
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:N
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 WESCOTT BLVD APT 7308
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9137
Mailing Address - Country:US
Mailing Address - Phone:843-344-1925
Mailing Address - Fax:
Practice Address - Street 1:337 BUCKWALTER PLACE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5175
Practice Address - Country:US
Practice Address - Phone:843-212-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty