Stewart, Olivia Dehavilland
Stewart, Olivia Dehavilland is an sole proprietor health care provider with primary practice located at 1268 Grindenwald Dr , Jonesboro GA 30238-8037. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Stewart, Olivia Dehavilland can be contacted via phone (770) 912-3634.Contact Information
Primary practice address
1268 Grindenwald Dr
Jonesboro GA 30238-8037
Phone: (770) 912-3634
Fax: (678) 610-1633
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LPC 004134 | Georgia |
Profile Details
| NPI number | 1942225974 |
|---|---|
| LBN Legal business name | Stewart, Olivia Dehavilland |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942225974 | NPPES |
| Georgia | MEDICAID | 477163794A |
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