Provider Demographics
NPI:1144254533
Name:STEWART, MELINDA ELAINE (LICSW)
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:ELAINE
Last Name:STEWART
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1934
Mailing Address - Country:US
Mailing Address - Phone:978-302-5940
Mailing Address - Fax:978-600-0286
Practice Address - Street 1:17 STEVENS ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1934
Practice Address - Country:US
Practice Address - Phone:978-302-5940
Practice Address - Fax:978-600-0286
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11322251041C0700X
MA1132251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical