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General NPI Number Information
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NPI Number | 1326581984
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Entity Type | Individual
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Provider Name | ROBERT RAY STEWART LISW-S, LICDC-CS
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Gender | Male
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 680 PARK AVE W
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City | MANSFIELD
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State | OH
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Zip | 44906-3706
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Country | US
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Telephone | 419-528-5993
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Fax | 567-560-5483
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Provider Business Mailing Address
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Address Line | 680 PARK AVE W
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City | MANSFIELD
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State | OH
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Zip | 44906-3706
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Country | US
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Telephone | 419-528-5993
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Fax | 567-560-8475
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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 | I.1302362-SUPV
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License Number State | OH
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