Provider Demographics
NPI:1174883383
Name:STONE, ERIC STEVEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:STEVEN
Last Name:STONE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 BRANDON ST APT 299
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-3653
Mailing Address - Country:US
Mailing Address - Phone:646-597-3018
Mailing Address - Fax:
Practice Address - Street 1:251 BRANDON ST APT 299
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-3653
Practice Address - Country:US
Practice Address - Phone:646-597-3018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0796341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300113317Medicare PIN