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NPI Code Detail

MEDICARE: GRACE CADE STEWART MS, NCC

MEDICARE: GRACE CADE STEWART MS, NCC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1407689995
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE CADE STEWART MS, NCC
Provider Business Mailing Address
First Line : 1351 PARIS MOUNTAIN RD
Second Line :
City : ROCKMART
State : GA
Zip : 30153-4613
Country : US
Telephone Number : 901-395-9850
Fax Number :
Provider Business Practice Location Address
First Line : 1640 POWERS FERRY RD SE BLDG 14-200
Second Line :
City : MARIETTA
State : GA
Zip : 30067-1459
Country : US
Telephone Number : 888-551-5168
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2024
Last Update Date : 08/21/2024

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