Provider Demographics
NPI:1770763906
Name:STEWART, MARCELA TERESA (LMSW, CASAC)
Entity type:Individual
Prefix:MS
First Name:MARCELA
Middle Name:TERESA
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CADMAN PLZ W FL 12
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3226
Mailing Address - Country:US
Mailing Address - Phone:347-628-7600
Mailing Address - Fax:347-402-0337
Practice Address - Street 1:395 PEARL ST
Practice Address - Street 2:SEL MEDICAL GROUP
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5138
Practice Address - Country:US
Practice Address - Phone:718-875-9500
Practice Address - Fax:718-875-7079
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19340101YA0400X
NY051593104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)