Provider Demographics
NPI:1407689995
Name:STEWART, GRACE CADE (MS, NCC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:CADE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 PARIS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKMART
Mailing Address - State:GA
Mailing Address - Zip Code:30153-4613
Mailing Address - Country:US
Mailing Address - Phone:901-395-9850
Mailing Address - Fax:
Practice Address - Street 1:1640 POWERS FERRY RD SE BLDG 14-200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-1459
Practice Address - Country:US
Practice Address - Phone:888-551-5168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health