Healthcare Provider Details

I. General information

NPI: 1356018717
Provider Name (Legal Business Name): ATIYA STEWART LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9635 UTICA PL
SPRINGDALE MD
20774-5449
US

IV. Provider business mailing address

9635 UTICA PL
SPRINGDALE MD
20774-5449
US

V. Phone/Fax

Practice location:
  • Phone: 301-887-3956
  • Fax:
Mailing address:
  • Phone: 301-887-3856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003880
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLG50082995
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: