Provider Demographics
NPI:1780991356
Name:STONE, JENNETTE EILEEN (LCSW)
Entity type:Individual
Prefix:
First Name:JENNETTE
Middle Name:EILEEN
Last Name:STONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 W ODELL DR
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2918
Mailing Address - Country:US
Mailing Address - Phone:385-832-8518
Mailing Address - Fax:
Practice Address - Street 1:4829 W ODELL DR
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84120-2918
Practice Address - Country:US
Practice Address - Phone:385-832-8518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker