Provider Demographics
NPI:1821763376
Name:STEWART, LANELL DARNELL (PSYD)
Entity Type:Individual
Prefix:MS
First Name:LANELL
Middle Name:DARNELL
Last Name:STEWART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22810 ATCHAFALAYA DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6976
Mailing Address - Country:US
Mailing Address - Phone:225-964-2696
Mailing Address - Fax:
Practice Address - Street 1:22810 ATCHAFALAYA DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6976
Practice Address - Country:US
Practice Address - Phone:225-964-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALS8610642103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling