Provider Demographics
NPI:1790857928
Name:STEWART, MARY E (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-2205
Mailing Address - Country:US
Mailing Address - Phone:860-956-8771
Mailing Address - Fax:
Practice Address - Street 1:995 DAY HILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1722
Practice Address - Country:US
Practice Address - Phone:860-731-5522
Practice Address - Fax:860-731-5536
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001389106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist