=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174693808
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEWART PSYCHOLOGICAL SERVICES, PLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2006
-----------------------------------------------------
Last Update Date | 08/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7920 KIRKLAND CT
-----------------------------------------------------
City | PORTAGE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49024-4974
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-345-0669
-----------------------------------------------------
Fax | 269-345-5354
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8469 E STURTEVANT AVE
-----------------------------------------------------
City | RICHLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49083-8543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-806-9571
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MEMBER
-----------------------------------------------------
Name | DR. EMILY STEWART STEVENS
-----------------------------------------------------
Credential | PSYD, MA
-----------------------------------------------------
Telephone | 269-806-9571
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TH0004X
-----------------------------------------------------
Taxonomy Name | Health Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------