Provider Demographics
NPI:1912383027
Name:MARIA STEWART
Entity Type:Organization
Organization Name:MARIA STEWART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT SUPPORTS COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:734-829-8950
Mailing Address - Street 1:230 S MINERVA AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3981
Mailing Address - Country:US
Mailing Address - Phone:734-829-8950
Mailing Address - Fax:
Practice Address - Street 1:230 S MINERVA AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3981
Practice Address - Country:US
Practice Address - Phone:734-829-8950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty