MEDICARE: DR. BRANDI JO STEWART PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS015707	PA
2	103TC2200X	Clinical Child & Adolescent Psychologist	PS015707	PA
3	103TF0200X	Forensic Psychologist	PS015707	PA

General Provider Information

NPI Number	:	1124197884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDI JO STEWART PSY.D.

Provider Business Mailing Address
First Line	:	708 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-2804
Country	:	US
Telephone Number	:	267-243-1159
Fax Number	:	215-965-5713

Provider Business Practice Location Address
First Line	:	9733 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-3201
Country	:	US
Telephone Number	:	215-885-3337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	09/11/2025

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