Provider Demographics
NPI:1720874688
Name:STEWART, ABIGAIL NICOLE
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:NICOLE
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 1:1601B EAGLES CREST AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1073
Mailing Address - Country:US
Mailing Address - Phone:630-297-1547
Mailing Address - Fax:
Practice Address - Street 1:1601B EAGLES CREST AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1073
Practice Address - Country:US
Practice Address - Phone:630-297-1547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health