Provider Demographics
NPI:1043783632
Name:STEWARD, JEFFREY ALAN
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALAN
Last Name:STEWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4312 OLD BIRMINGHAM HWY
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-8803
Mailing Address - Country:US
Mailing Address - Phone:256-283-8530
Mailing Address - Fax:
Practice Address - Street 1:4312 OLD BIRMINGHAM HWY
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-8803
Practice Address - Country:US
Practice Address - Phone:256-283-8530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional