Provider Demographics
NPI:1285477414
Name:STEWART, GERMAINE THOMAS
Entity type:Individual
Prefix:MR
First Name:GERMAINE
Middle Name:THOMAS
Last Name:STEWART
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 1:1008 FLINT HILL ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5609
Mailing Address - Country:US
Mailing Address - Phone:803-659-4274
Mailing Address - Fax:
Practice Address - Street 1:1008 FLINT HILL ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5609
Practice Address - Country:US
Practice Address - Phone:803-659-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor