Provider Demographics
NPI:1063130409
Name:STEWART, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:STEWART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 WILSHIRE BLVD STE 850
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5014
Mailing Address - Country:US
Mailing Address - Phone:310-341-4887
Mailing Address - Fax:
Practice Address - Street 1:6380 WILSHIRE BLVD STE 850
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5014
Practice Address - Country:US
Practice Address - Phone:310-341-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CACI44630924101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)