Healthcare Provider Details

I. General information

NPI: 1053700666
Provider Name (Legal Business Name): STONE CITY COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 01/20/2015
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

Practice location:
  • Phone: 812-279-4673
  • Fax: 812-279-4672
Mailing address:
  • Phone: 812-279-4673
  • Fax: 812-279-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34005726A
License Number StateIN

VIII. Authorized Official

Name: SHARON KRISTINE ADAMS
Title or Position: OWNER, THERAPIST
Credential: MSW, LCSW
Phone: 812-279-4673