MEDICARE: MS. BROOKE NICOLE STEWART LPC-MHSP

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1467590182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BROOKE NICOLE STEWART LPC-MHSP

Provider Business Mailing Address
First Line	:	7626 ASHSTONE CV
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-1703
Country	:	US
Telephone Number	:	901-619-7056
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 BROAD AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-3104
Country	:	US
Telephone Number	:	901-619-7056
Fax Number	:

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	04/30/2025

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