MEDICARE: ELEANOR MCMICHAEL STEWART M.ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0000369	GA

General Provider Information

NPI Number	:	1003168469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELEANOR MCMICHAEL STEWART M.ED.

Provider Business Mailing Address
First Line	:	3525 PIEDMONT ROAD
Second Line	:	PIEDMONT CENTER, BLDG. EIGHT
City	:	ATLANTA
State	:	GA
Zip	:	30305
Country	:	US
Telephone Number	:	404-550-4210
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 PIEDMONT RD NE
Second Line	:	PIEDMONT CENTER, BLDG. 8, SUITE 102
City	:	ATLANTA
State	:	GA
Zip	:	30305-1578
Country	:	US
Telephone Number	:	404-550-4210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	10/10/2012

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