Provider Demographics
NPI:1972818573
Name:MARGUERITE STEWART, P.C.
Entity Type:Organization
Organization Name:MARGUERITE STEWART, P.C.
Other - Org Name:MARGUERITE STEWART, PSY.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-778-9989
Mailing Address - Street 1:P. O. BOX 101062
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-1062
Mailing Address - Country:US
Mailing Address - Phone:303-778-9989
Mailing Address - Fax:303-871-0992
Practice Address - Street 1:3955 E EXPOSITION AVE
Practice Address - Street 2:SUITE 408
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5000
Practice Address - Country:US
Practice Address - Phone:303-778-9989
Practice Address - Fax:303-871-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1641103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA101379OtherMEDICARE INDIVIDUAL PTAN
CO07016413Medicaid
CO07016413Medicaid
COC89896Medicare Oscar/Certification
COCOA101378Medicare PIN