Provider Demographics
NPI:1649552696
Name:STEWART, RACHEL CORBAN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CORBAN
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 OAK RIDGE CT
Mailing Address - Street 2:UNIT 404
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9369
Mailing Address - Country:US
Mailing Address - Phone:239-910-0412
Mailing Address - Fax:
Practice Address - Street 1:2734 OAK RIDGE CT
Practice Address - Street 2:UNIT 404
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9369
Practice Address - Country:US
Practice Address - Phone:239-910-0412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health