Provider Demographics
NPI: | 1093856510 |
---|---|
Name: | JOHN H. STEWART |
Entity Type: | Organization |
Organization Name: | JOHN H. STEWART |
Other - Org Name: | A RENEWED HOPE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | HOWARD |
Authorized Official - Last Name: | STEWART |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MFT |
Authorized Official - Phone: | 530-272-7448 |
Mailing Address - Street 1: | 908 TAYLORVILLE RD. |
Mailing Address - Street 2: | STE. 206 |
Mailing Address - City: | GRASS VALLEY |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95949 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 530-272-7448 |
Mailing Address - Fax: | 530-272-9904 |
Practice Address - Street 1: | 908 TAYLORVILLE RD. |
Practice Address - Street 2: | STE. 206 |
Practice Address - City: | GRASS VALLEY |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95949 |
Practice Address - Country: | US |
Practice Address - Phone: | 530-272-7448 |
Practice Address - Fax: | 530-272-9904 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-08 |
Last Update Date: | 2015-09-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Single Specialty |