Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3145 | MA |
Y | 103TC0700X | Clinical Psychologist | 3145 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3145 | MA |
NPI | 1073600607 |
---|---|
Provider Name | Dr. Carolyn R Stone |
First Address | Newton Highlands, MA 02461 |
Second Address | Newton Highlands, MA 02461-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 22/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110325000 | MAGELLAN BEHAVIORAL HEALT (01) | MA |
729246 | TUFT HEALTH PLAN (01) | MA |