Provider Demographics
NPI:1144613456
Name:STEWART, LAURA ANN (PSYD)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:KIRBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17500 NORTH PERIMETER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255
Mailing Address - Country:US
Mailing Address - Phone:480-586-2300
Mailing Address - Fax:602-586-2211
Practice Address - Street 1:8322 E HARTFORD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5402
Practice Address - Country:US
Practice Address - Phone:480-712-4600
Practice Address - Fax:602-428-7045
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4377103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ115738Medicaid