Healthcare Provider Details

I. General information

NPI: 1164295135
Provider Name (Legal Business Name): BOBBI JO STONE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 11/01/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 COUNTY ROUTE 26
DOWNSVILLE NY
13755
US

IV. Provider business mailing address

PO BOX 84
DOWNSVILLE NY
13755-0084
US

V. Phone/Fax

Practice location:
  • Phone: 607-238-9085
  • Fax:
Mailing address:
  • Phone: 607-238-9085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BOBBI JO STONE
Title or Position: OWNER
Credential: LCSW
Phone: 607-238-9085