Healthcare Provider Details

I. General information

NPI: 1710702170
Provider Name (Legal Business Name): STEWART OF HEALING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9423 GRAND SPARK DR
ROSHARON TX
77583-3375
US

IV. Provider business mailing address

7737 LEEDS CASTLE LN
NEW KENT VA
23124-2641
US

V. Phone/Fax

Practice location:
  • Phone: 804-572-6662
  • Fax:
Mailing address:
  • Phone: 804-572-6629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS STEWART
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 804-572-6629