Provider Demographics
NPI:1770630808
Name:STEWART, CYNTHIA ELIZABETH (MA)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:STEWART
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 WOODMERE CT
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-8748
Mailing Address - Country:US
Mailing Address - Phone:859-242-0702
Mailing Address - Fax:859-242-0702
Practice Address - Street 1:2059 WOODMERE CT
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-8748
Practice Address - Country:US
Practice Address - Phone:859-242-0702
Practice Address - Fax:859-242-0702
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health