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General NPI Number Information
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NPI Number | 1104424399
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Entity Type | Individual
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Provider Name | SHAYLA T. STEWART LISW-CP, LCSW, MPA
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Gender | Female
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 3205 FREEDOM DR STE 2000
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City | CHARLOTTE
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State | NC
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Zip | 28208-3486
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Country | US
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Telephone | 704-975-7343
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Fax |
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Provider Business Mailing Address
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Address Line | 2267 EDEN TER APT 202
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City | ROCK HILL
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State | SC
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Zip | 29730-2818
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Country | US
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Telephone | 706-877-0357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10969
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C013864
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License Number State | NC
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