Provider Demographics
NPI:1548278336
Name:STEWART, ROBERT (PSYD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:STEWART
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 24TH ST
Mailing Address - Street 2:KENNER ARMY HEALTH CLINIC
Mailing Address - City:FORT LEE
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1716
Mailing Address - Country:US
Mailing Address - Phone:804-734-9942
Mailing Address - Fax:877-874-1008
Practice Address - Street 1:1350 COCHRANE CIRCLE
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-1840
Practice Address - Fax:703-805-0731
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002715103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist