Provider Demographics
NPI:1962057513
Name:STEWART, JORDAN (PSYD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-1135
Mailing Address - Country:US
Mailing Address - Phone:630-336-5011
Mailing Address - Fax:
Practice Address - Street 1:210 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1010
Practice Address - Country:US
Practice Address - Phone:518-580-0520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor