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NPI Code Detail

MEDICARE: BRYAN JOEL STEWART CDCA

MEDICARE: BRYAN JOEL STEWART CDCA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor185163MI
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA185163OH
3101YA0400XAddiction (Substance Use Disorder) Counselor185163OH

General Provider Information

NPI Number : 1720862493
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN JOEL STEWART CDCA
Provider Business Mailing Address
First Line : 4145 WEBSTER AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-3637
Country : US
Telephone Number : 513-908-1796
Fax Number :
Provider Business Practice Location Address
First Line : 5122 GLENCROSSING WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3361
Country : US
Telephone Number : 513-827-9044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2023
Last Update Date : 08/23/2023

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Directions to “ BRYAN JOEL STEWART CDCA” Practice Location

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