MEDICARE: STACEY HENSLER STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist		MO

General Provider Information

NPI Number	:	1205923794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STACEY HENSLER STONE

Provider Business Mailing Address
First Line	:	1600 HERITAGE LANDING
Second Line	:	STE 100
City	:	ST CHARLES
State	:	MO
Zip	:	63303-8490
Country	:	US
Telephone Number	:	314-205-1828
Fax Number	:	636-441-9909

Provider Business Practice Location Address
First Line	:	1600 HERITAGE LANDING
Second Line	:	STE 100
City	:	ST CHARLES
State	:	MO
Zip	:	63303-8490
Country	:	US
Telephone Number	:	314-205-1828
Fax Number	:	636-441-9909

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	STACEY L HENSLER STONE
Credential	:	LCSW
Telephone Number	:	314-205-1828

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/22/2020

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Directions to “STACEY HENSLER STONE ” Practice Location

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