Provider Demographics
NPI:1548868821
Name:WHITE STONE PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:WHITE STONE PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:314-915-2233
Mailing Address - Street 1:613 BIG BEND RD # 857
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-9998
Mailing Address - Country:US
Mailing Address - Phone:314-915-2233
Mailing Address - Fax:
Practice Address - Street 1:613 BIG BEND RD # 857
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-9998
Practice Address - Country:US
Practice Address - Phone:314-915-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)