Healthcare Provider Details
I. General information
NPI: 1881848448
Provider Name (Legal Business Name): STONE CITY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2008
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2325 Q ST
BEDFORD IN
47421-4718
US
IV. Provider business mailing address
2325 Q ST
BEDFORD IN
47421-4718
US
V. Phone/Fax
- Phone: 812-279-4673
- Fax: 812-279-4672
- Phone: 812-279-4673
- Fax: 812-279-4672
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHARON
ADAMS
Title or Position: CEO
Credential: MSW, LCSW
Phone: 812-279-4673