Provider Demographics
NPI:1942389630
Name:STEWART, TAMIKA H (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:H
Last Name:STEWART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 ARCH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-2116
Mailing Address - Country:US
Mailing Address - Phone:267-256-4566
Mailing Address - Fax:267-256-4562
Practice Address - Street 1:1321 ARCH ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-2116
Practice Address - Country:US
Practice Address - Phone:267-256-4566
Practice Address - Fax:267-256-4562
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0151001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical