Provider Demographics
NPI:1962646356
Name:STEWART, STEPHANIE N (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:N
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 310994
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31131-0994
Mailing Address - Country:US
Mailing Address - Phone:404-513-5492
Mailing Address - Fax:770-936-1946
Practice Address - Street 1:3350 RIVERWOOD PKWY
Practice Address - Street 2:SUITE 1900
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:404-513-5492
Practice Address - Fax:770-936-1946
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional