MEDICARE: MARJORIE STEWART MH-18289

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	101YP2500X	Professional Counselor	MH-18289	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	684962	OTHER	AK	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1336348036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE STEWART MH-18289

Provider Business Mailing Address
First Line	:	111 S BEDFORD ST STE 205
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-5145
Country	:	US
Telephone Number	:	617-982-0181
Fax Number	:

Provider Business Practice Location Address
First Line	:	2216 HIGHWAY 44 W
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34453-3860
Country	:	US
Telephone Number	:	613-982-0181
Fax Number	:

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	09/13/2023

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