Provider Demographics
NPI:1326337973
Name:STEWART, ALLEN (LPC)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 WINTON BLOUNT LOOP
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3507
Mailing Address - Country:US
Mailing Address - Phone:334-270-5502
Mailing Address - Fax:334-270-5503
Practice Address - Street 1:233 WINTON BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3507
Practice Address - Country:US
Practice Address - Phone:334-270-5502
Practice Address - Fax:334-270-5503
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL753101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health