Healthcare Provider Details

I. General information

NPI: 1366783961
Provider Name (Legal Business Name): KARA STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA WINSLEY

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 GLYNN ST S STE 127
FAYETTEVILLE GA
30214-2077
US

IV. Provider business mailing address

805 GLYNN ST S STE 127
FAYETTEVILLE GA
30214-2077
US

V. Phone/Fax

Practice location:
  • Phone: 877-358-2998
  • Fax: 423-405-6346
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC009200
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: