Provider Demographics
NPI:1013527514
Name:STEWART, HANNAH MARY MOXLEY (MA LMFTA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARY MOXLEY
Last Name:STEWART
Suffix:
Gender:F
Credentials:MA LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 BLACK TUPELO CT
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-2907
Mailing Address - Country:US
Mailing Address - Phone:559-801-4005
Mailing Address - Fax:
Practice Address - Street 1:213 BLACK TUPELO CT
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-2907
Practice Address - Country:US
Practice Address - Phone:559-801-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID106S00000X
SC10202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty