Provider Demographics
NPI:1205923794
Name:STACEY HENSLER STONE
Entity type:Organization
Organization Name:STACEY HENSLER STONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENSLER STONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-205-1828
Mailing Address - Street 1:1600 HERITAGE LANDING
Mailing Address - Street 2:STE 100
Mailing Address - City:ST CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-8490
Mailing Address - Country:US
Mailing Address - Phone:314-205-1828
Mailing Address - Fax:636-441-9909
Practice Address - Street 1:1600 HERITAGE LANDING
Practice Address - Street 2:STE 100
Practice Address - City:ST CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-8490
Practice Address - Country:US
Practice Address - Phone:314-205-1828
Practice Address - Fax:636-441-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========Medicare UPIN