Healthcare Provider Details

I. General information

NPI: 1124743729
Provider Name (Legal Business Name): CHELSEA RAE STONE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41800 W 11 MILE RD STE 110
NOVI MI
48375-1818
US

IV. Provider business mailing address

880 TEGGERDINE RD
WHITE LAKE MI
48386-1728
US

V. Phone/Fax

Practice location:
  • Phone: 877-693-5543
  • Fax: 248-221-1775
Mailing address:
  • Phone: 248-981-3274
  • Fax: 248-221-1775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401226252
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: