Provider Demographics
NPI:1386898534
Name:STONE, EDITH A (MA, LPC)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:A
Last Name:STONE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:EDIE
Other - Middle Name:
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:2027 BROADWAY ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5265
Mailing Address - Country:US
Mailing Address - Phone:303-415-3755
Mailing Address - Fax:
Practice Address - Street 1:2027 BROADWAY ST
Practice Address - Street 2:SUITE H
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5265
Practice Address - Country:US
Practice Address - Phone:303-415-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional