Provider Demographics
NPI:1417216748
Name:STEWART, JEFFREY M (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:M
Last Name:STEWART
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5260 BRIDLE LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9339
Mailing Address - Country:US
Mailing Address - Phone:989-303-8998
Mailing Address - Fax:
Practice Address - Street 1:5260 BRIDLE LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-9339
Practice Address - Country:US
Practice Address - Phone:989-303-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006446106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist