Provider Demographics
NPI:1932556701
Name:STEWARD, CHAD (MHS)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:STEWARD
Suffix:
Gender:M
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:LA
Mailing Address - Zip Code:70342-0073
Mailing Address - Country:US
Mailing Address - Phone:985-518-4746
Mailing Address - Fax:985-308-0804
Practice Address - Street 1:8326 KELWOOD AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4803
Practice Address - Country:US
Practice Address - Phone:985-518-4746
Practice Address - Fax:985-308-0804
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 101YM0800X
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600859733Medicaid