Healthcare Provider Details

I. General information

NPI: 1770690794
Provider Name (Legal Business Name): JAMES CHRISTOPHER STEWART PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 PIKES PEAK AVE
COLORADO SPRINGS CO
80903
US

IV. Provider business mailing address

2020 BRAMBLWOOD LN
COLORADO SPRINGS CO
80920-1588
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-8325
  • Fax: 719-776-8568
Mailing address:
  • Phone: 719-244-5652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 1696
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: