Provider Demographics
NPI:1477942381
Name:STEWART, ROSALIND
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 CAPITOL TRAIL
Mailing Address - Street 2:POLLY DRUMMOND PLAZA , BUILDING 3
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5703
Mailing Address - Country:US
Mailing Address - Phone:901-563-8600
Mailing Address - Fax:
Practice Address - Street 1:1423 CAPITOL TRAIL
Practice Address - Street 2:POLLY DRUMMOND PLAZA, BUILDING 3
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5703
Practice Address - Country:US
Practice Address - Phone:901-563-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2018-07-06
Deactivation Date:2015-11-10
Deactivation Code:
Reactivation Date:2018-05-23
Provider Licenses
StateLicense IDTaxonomies
DECD-0000098101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)