Provider Demographics
NPI:1568838316
Name:THE STONE FOUNDATION
Entity type:Organization
Organization Name:THE STONE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DERISO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-296-2004
Mailing Address - Street 1:320 E TOWSONTOWN BLVD
Mailing Address - Street 2:SUITE 2W
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5318
Mailing Address - Country:US
Mailing Address - Phone:410-296-2004
Mailing Address - Fax:410-296-0094
Practice Address - Street 1:320 E TOWSONTOWN BLVD
Practice Address - Street 2:SUITE 2W
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5318
Practice Address - Country:US
Practice Address - Phone:410-296-2004
Practice Address - Fax:410-296-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty