Provider Demographics
NPI:1184689176
Name:STEWART, HAROLD T (LCSW LADC CCS)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:T
Last Name:STEWART
Suffix:
Gender:M
Credentials:LCSW LADC CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 COCHRANE CIR BLDG 7505
Mailing Address - Street 2:
Mailing Address - City:FT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4604
Mailing Address - Country:US
Mailing Address - Phone:719-526-5231
Mailing Address - Fax:719-526-7732
Practice Address - Street 1:1076 SWITCH GRASS DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-3529
Practice Address - Country:US
Practice Address - Phone:720-601-3252
Practice Address - Fax:720-601-3252
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC2593101YA0400X
COCSW099243541041C0700X
MELC110501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME295960099Medicaid
MECCS3210OtherCERTIFIED CLINICAL SUPER