Provider Demographics
NPI:1992245203
Name:STEWART, SUSAN L (LMFT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 S MAIN ST # 203
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2532
Mailing Address - Country:US
Mailing Address - Phone:717-217-3980
Mailing Address - Fax:717-754-2844
Practice Address - Street 1:166 S MAIN ST # 203
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2532
Practice Address - Country:US
Practice Address - Phone:717-217-3980
Practice Address - Fax:717-754-2844
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14141449OtherCAQH