MEDICARE: ELIZABETH STEWARD

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	:	1639017189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH STEWARD

Provider Business Mailing Address
First Line	:	129 JENNIFER DR
Second Line	:
City	:	NEW LLANO
State	:	LA
Zip	:	71461-4522
Country	:	US
Telephone Number	:	337-423-6167
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 JAMESTOWN ST UNIT J
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5711
Country	:	US
Telephone Number	:	337-508-2313
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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