MEDICARE: JANICE 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	101Y00000X	Counselor
2	101Y00000X	Counselor	0701007754	VA

General Provider Information

NPI Number	:	1932687142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE STEWART

Provider Business Mailing Address
First Line	:	301 DOROTHY DR
Second Line	:
City	:	YORKTOWN
State	:	VA
Zip	:	23692-5702
Country	:	US
Telephone Number	:	757-364-9872
Fax Number	:

Provider Business Practice Location Address
First Line	:	3804 GEORGE WASHINGTON MEM HWY
Second Line	:
City	:	YORKTOWN
State	:	VA
Zip	:	23692
Country	:	US
Telephone Number	:	757-898-7926
Fax Number	:

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

Provider Enumeration Date	:	07/31/2018
Last Update Date	:	09/07/2018

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Directions to “ JANICE STEWART ” Practice Location

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