MEDICARE: MS. BETSEY G STONE LICSW

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	1041C0700X	Clinical Social Worker	101608	MA

General Provider Information

NPI Number	:	1841348430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETSEY G STONE LICSW

Provider Business Mailing Address
First Line	:	130 MOUNT AUBURN ST
Second Line	:	APARTMENT 302
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-5757
Country	:	US
Telephone Number	:	617-864-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 N MAIN ST
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-1100
Country	:	US
Telephone Number	:	508-653-7830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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