Provider Demographics
NPI:1053449678
Name:STEWART, SUSAN MILLER (MSSW, CMSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MILLER
Last Name:STEWART
Suffix:
Gender:F
Credentials:MSSW, CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 CHAPMANS RETREAT DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-7132
Mailing Address - Country:US
Mailing Address - Phone:615-302-0195
Mailing Address - Fax:
Practice Address - Street 1:902 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3204
Practice Address - Country:US
Practice Address - Phone:931-698-4674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTBA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker