Provider Demographics
NPI:1245360494
Name:STEWART THOMAS, ERIC STEVEN (LMFT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:STEVEN
Last Name:STEWART THOMAS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MONROVISTA AVE UNIT B
Mailing Address - Street 2:MONROVIA
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-4672
Mailing Address - Country:US
Mailing Address - Phone:626-622-2501
Mailing Address - Fax:
Practice Address - Street 1:317 S PRIMROSE AVE
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2858
Practice Address - Country:US
Practice Address - Phone:626-622-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC51552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist