Healthcare Provider Details

I. General information

NPI: 1679604474
Provider Name (Legal Business Name): CYNTHIA MARY STEWART LCSW-BACS, BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 STATE ST
NEW ORLEANS LA
70118-5735
US

IV. Provider business mailing address

316 MILLAUDON ST
NEW ORLEANS LA
70118-3712
US

V. Phone/Fax

Practice location:
  • Phone: 504-897-4741
  • Fax: 504-896-4918
Mailing address:
  • Phone: 504-861-9284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2724
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: