Healthcare Provider Details

I. General information

NPI: 1104884758
Provider Name (Legal Business Name): PATRICIA J STEWART MED LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 207P
BEVERLY MA
01915-6104
US

IV. Provider business mailing address

100 CUMMINGS CTR STE 207P
BEVERLY MA
01915-6104
US

V. Phone/Fax

Practice location:
  • Phone: 603-767-7144
  • Fax: 978-388-3342
Mailing address:
  • Phone: 603-767-7144
  • Fax: 978-388-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5980
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: