Healthcare Provider Details

I. General information

NPI: 1306510219
Provider Name (Legal Business Name): ELEANA STEWART LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 OLD WASHINGTON RD STE 2020
WALDORF MD
20602-3231
US

IV. Provider business mailing address

PO BOX 34
BRANDYWINE MD
20613-0034
US

V. Phone/Fax

Practice location:
  • Phone: 301-375-0548
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17343
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: