Provider Demographics
NPI:1437239241
Name:STEWART, JAN (LISW)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COPELAND MILL RD.
Mailing Address - Street 2:STE 1E
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8977
Mailing Address - Country:US
Mailing Address - Phone:614-561-6800
Mailing Address - Fax:
Practice Address - Street 1:575 COPELAND MILL RD
Practice Address - Street 2:STE 1E
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8977
Practice Address - Country:US
Practice Address - Phone:614-561-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-42841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical