Provider Demographics
NPI:1639510266
Name:STEWART, LINDSAY (PHD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1256 BRIARCLIFF RD NE
Mailing Address - Street 2:SUITE 304-E
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2636
Mailing Address - Country:US
Mailing Address - Phone:404-727-4573
Mailing Address - Fax:
Practice Address - Street 1:1256 BRIARCLIFF RD NE
Practice Address - Street 2:SUITE 304-E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2636
Practice Address - Country:US
Practice Address - Phone:404-727-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003577103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent