| Doctor Name: | MR. THOMAS RICHARD STEWART |
| NPI Number: | 1043423890 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LLP |
| License Number: | 6301011054 |
| Business Practice Address: | 4670 Fulton St E Suite 101 Ada, MI - 493018455 |
| Business Phone Number: | 6165605954 |
| Business Fax Number: | 6169753163 |
| Mailing Address: | 2515 Leonard St Nw, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495043757 |
| Phone Number: | 6065605954 |
| Fax Number: | 6169753163 |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 6301011054 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |