Provider Demographics
NPI:1770632267
Name:STEWART, DONALD A, (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A,
Last Name:STEWART
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 N ATLANTIC AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3273
Mailing Address - Country:US
Mailing Address - Phone:321-784-1888
Mailing Address - Fax:321-784-1894
Practice Address - Street 1:1980 N ATLANTIC AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-5213
Practice Address - Country:US
Practice Address - Phone:321-784-1888
Practice Address - Fax:321-784-1894
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY-3458103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical