Provider Demographics
NPI:1558031872
Name:STEWART, MICHELE YVONNE (ALC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:YVONNE
Last Name:STEWART
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 BOB WALLACE AVE SW STE 1
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-4007
Mailing Address - Country:US
Mailing Address - Phone:256-686-9195
Mailing Address - Fax:256-304-5381
Practice Address - Street 1:3309 BOB WALLACE AVE SW STE 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-4007
Practice Address - Country:US
Practice Address - Phone:256-686-9195
Practice Address - Fax:256-304-5381
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health