Provider Demographics
NPI:1538599337
Name:STONE, BROOKE N (MFT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:N
Last Name:STONE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 MCCOURTNEY RD STE C
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-7401
Mailing Address - Country:US
Mailing Address - Phone:530-559-1500
Mailing Address - Fax:530-231-2999
Practice Address - Street 1:944 MCCOURTNEY RD STE C
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949-7401
Practice Address - Country:US
Practice Address - Phone:530-559-1500
Practice Address - Fax:530-231-2999
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist