Provider Demographics
NPI:1659516599
Name:STEWART, STEVEN BURNELL (LPC, LADC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:BURNELL
Last Name:STEWART
Suffix:
Gender:M
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 S ROCKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3804
Mailing Address - Country:US
Mailing Address - Phone:918-361-3682
Mailing Address - Fax:
Practice Address - Street 1:6750 S ROCKFORD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3804
Practice Address - Country:US
Practice Address - Phone:918-361-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK234101YA0400X
OK1498101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)