Provider Demographics
NPI:1386172526
Name:STONE, AUDREY LYNN (AA, CADC)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:AA, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6663 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-1001
Mailing Address - Country:US
Mailing Address - Phone:515-537-0616
Mailing Address - Fax:
Practice Address - Street 1:6663 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-1001
Practice Address - Country:US
Practice Address - Phone:515-537-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty