Provider Demographics
NPI:1902921620
Name:STEWART, PAUL MARK (LCSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:MARK
Last Name:STEWART
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 PEARL ST
Mailing Address - Street 2:SUITE A-28
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3061
Mailing Address - Country:US
Mailing Address - Phone:831-372-8594
Mailing Address - Fax:831-372-8595
Practice Address - Street 1:444 PEARL ST
Practice Address - Street 2:SUITE A-28
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3061
Practice Address - Country:US
Practice Address - Phone:831-372-8594
Practice Address - Fax:831-372-8595
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS128641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical