Provider Demographics
NPI:1851180178
Name:STEWART, LISA ANN (CLWC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:CLWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 MEADOW HILL DR APT 54
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3967
Mailing Address - Country:US
Mailing Address - Phone:366-422-8674
Mailing Address - Fax:
Practice Address - Street 1:324 MEADOW HILL DR APT 54
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-3967
Practice Address - Country:US
Practice Address - Phone:336-422-8674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health