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General NPI Number Information
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NPI Number | 1679418016
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Entity Type | Individual
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Provider Name | MICHAEL J STEWRT
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Gender | Male
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 4824 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4225
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Country | US
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Telephone | 215-738-7011
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 FRUIT ST
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City | ERIE
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State | PA
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Zip | 16504-2021
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC020183
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License Number State | PA
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