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General NPI Number Information
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NPI Number | 1588701817
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Entity Type | Individual
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Provider Name | JEFFREY L STEWART L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 16301 SONOMA PARK DRIVE
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-620-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 14621 LAMPLIGHT LANE
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City | EDMOND
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State | OK
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Zip | 73013-1547
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Country | US
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Telephone | 405-620-4242
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Fax | 405-302-1265
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC2540
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2540
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License Number State | OK
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