Provider Demographics
NPI:1275144602
Name:STEWART, SYNTHIA ELAINA (LCSW)
Entity Type:Individual
Prefix:
First Name:SYNTHIA
Middle Name:ELAINA
Last Name:STEWART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PRESIDENTS WAY
Mailing Address - Street 2:
Mailing Address - City:VENUS
Mailing Address - State:TX
Mailing Address - Zip Code:76084-1113
Mailing Address - Country:US
Mailing Address - Phone:817-688-3229
Mailing Address - Fax:
Practice Address - Street 1:103 PRESIDENTS WAY
Practice Address - Street 2:
Practice Address - City:VENUS
Practice Address - State:TX
Practice Address - Zip Code:76084-1113
Practice Address - Country:US
Practice Address - Phone:817-688-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL103551041C0700X
VA09040108831041C0700X
TX597381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical