Provider Demographics
NPI:1174879027
Name:STEWART, DOMINIQUE REBECCA (MSW)
Entity type:Individual
Prefix:MS
First Name:DOMINIQUE
Middle Name:REBECCA
Last Name:STEWART
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 PRIMROSE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:504-278-4007
Practice Address - Street 1:3801 CANAL ST STE 220
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-482-2735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker