Basic Information
| Provider Information | |||||||||
| NPI: | 1952606014 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEWART | ||||||||
| FirstName: | LAWANDA | ||||||||
| MiddleName: | FELICIA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LISW-S | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 4440 POTH RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432131324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147519068 | ||||||||
| FaxNumber: | 6147519130 | ||||||||
| Practice Location | |||||||||
| Address1: | 4440 POTH RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432131324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6147519068 | ||||||||
| FaxNumber: | 6147519130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2011 | ||||||||
| LastUpdateDate: | 01/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I0700378 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.