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NPI Code Detail

MEDICARE: AMBER STEWART MS, LPC

MEDICARE: AMBER STEWART MS, LPC
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
1101Y00000XCounselor4081OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174791693
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER STEWART MS, LPC
Provider Business Mailing Address
First Line : 711 S MUSKOGEE AVE
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-4717
Country : US
Telephone Number : 918-207-0078
Fax Number : 918-207-0558
Provider Business Practice Location Address
First Line : 711 S MUSKOGEE AVE
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-4717
Country : US
Telephone Number : 918-207-0078
Fax Number : 918-207-0558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2008
Last Update Date : 04/18/2013

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