Basic Information
Provider Information
NPI: 1013098128
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEWART
FirstName: HELEN
MiddleName: ROSE
NamePrefix: MS.
NameSuffix:  
Credential: MSW LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 PARK CIRCLE DRIVE
Address2: 3K
City: WHEATON
State: IL
PostalCode: 60187
CountryCode: US
TelephoneNumber: 6309339403
FaxNumber:  
Practice Location
Address1: 6918 WINDSOR
Address2:  
City: BERWYN
State: IL
PostalCode: 60402
CountryCode: US
TelephoneNumber: 7087954800
FaxNumber: 7087954834
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X ILY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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