Provider Demographics
NPI:1619559333
Name:STONEROCK, SARAH ANNE (MED, LBA, QBA, BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:STONEROCK
Suffix:
Gender:F
Credentials:MED, LBA, QBA, BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:345 DEVERS ST STE 101&102
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 DEVERS ST STE 101&102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4752
Practice Address - Country:US
Practice Address - Phone:609-439-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14035103K00000X, 103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician