=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770226482
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT WINTON STONE LMSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2022
-----------------------------------------------------
Last Update Date | 04/19/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2900 CLAY EDWARDS DR
-----------------------------------------------------
City | NORTH KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64116-3235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-803-9532
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14617 E PHELPS CT
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64055-3557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 161-950-8621
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | LMSW12517
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------