MEDICARE: MELISSA STEWART

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	251S00000X	Community/Behavioral Health Agency	1332	NC
2	251S00000X	Community/Behavioral Health Agency	3115	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144418831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELISSA STEWART

Provider Business Mailing Address
First Line	:	1017 MEDLIN DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-4366
Country	:	US
Telephone Number	:	919-618-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 MORSON ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27601-1559
Country	:	US
Telephone Number	:	919-618-7217
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ OPERATOR- PSYCHOTHERAPIST
Name	:	MELISSA BRINSON STEWART
Credential	:	MS, LPC, ACS, LCAS
Telephone Number	:	919-618-7217

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	04/06/2009

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Directions to “MELISSA STEWART ” Practice Location

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