Provider Demographics
NPI:1891237715
Name:STEWART, LINDA CHERYL (LLPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CHERYL
Last Name:STEWART
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:CHERYL
Other - Last Name:STEWART-HARPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLPC
Mailing Address - Street 1:6549 TOWN CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:248-620-6400
Mailing Address - Fax:
Practice Address - Street 1:32961 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1729
Practice Address - Country:US
Practice Address - Phone:248-855-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015637101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1669451944Medicaid
MI382833497Medicaid
MI382833497Other1669451944