Provider Demographics
NPI:1427719228
Name:STEWART, JULIANNE S
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:S
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 FISHERMANS LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1623
Mailing Address - Country:US
Mailing Address - Phone:253-820-6044
Mailing Address - Fax:
Practice Address - Street 1:17932 FRALEY BLVD STE 240
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2456
Practice Address - Country:US
Practice Address - Phone:571-636-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014033101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor