Provider Demographics
NPI:1376015677
Name:STEWART, EMILIO JR (LGSW)
Entity Type:Individual
Prefix:MR
First Name:EMILIO
Middle Name:
Last Name:STEWART
Suffix:JR
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-5661
Mailing Address - Country:US
Mailing Address - Phone:302-260-5293
Mailing Address - Fax:
Practice Address - Street 1:4501 PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-5661
Practice Address - Country:US
Practice Address - Phone:302-260-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker