Provider Demographics
NPI:1841672771
Name:REMELE, STEWART
Entity type:Individual
Prefix:
First Name:STEWART
Middle Name:
Last Name:REMELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 LITTLE FOX RUN
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-1664
Mailing Address - Country:US
Mailing Address - Phone:203-500-9510
Mailing Address - Fax:203-225-0755
Practice Address - Street 1:41 LITTLE FOX RUN
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-1664
Practice Address - Country:US
Practice Address - Phone:203-500-9510
Practice Address - Fax:203-225-0755
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-27
Last Update Date:2015-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional