Provider Demographics
NPI:1083692990
Name:STEWART, DARLENE LEE (LICENSED MENTAL HEAL)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:LEE
Last Name:STEWART
Suffix:
Gender:F
Credentials:LICENSED MENTAL HEAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 S BEACH ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5035
Mailing Address - Country:US
Mailing Address - Phone:386-238-3830
Mailing Address - Fax:286-239-6918
Practice Address - Street 1:344 S BEACH ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5035
Practice Address - Country:US
Practice Address - Phone:386-238-3830
Practice Address - Fax:286-239-6918
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1332101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor