Provider Demographics
NPI:1649414350
Name:STEWART, JONI C (LCSW)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:C
Last Name:STEWART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E OAK AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-2318
Mailing Address - Country:US
Mailing Address - Phone:813-277-0080
Mailing Address - Fax:813-209-0564
Practice Address - Street 1:310 E OAK AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-2318
Practice Address - Country:US
Practice Address - Phone:813-277-0080
Practice Address - Fax:813-209-0564
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 22811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical