Provider Demographics
NPI:1972844389
Name:STEWART, MELISSA LYNN (LSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:STEWART
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 3RD ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2420
Mailing Address - Country:US
Mailing Address - Phone:724-728-1666
Mailing Address - Fax:724-728-1660
Practice Address - Street 1:1607 3RD ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2420
Practice Address - Country:US
Practice Address - Phone:724-728-1666
Practice Address - Fax:724-728-1660
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130309104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker