Provider Demographics
NPI:1144875485
Name:STEWART, LAKISHA J (LSW)
Entity type:Individual
Prefix:
First Name:LAKISHA
Middle Name:J
Last Name:STEWART
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 MANOR DR APT B
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4612
Mailing Address - Country:US
Mailing Address - Phone:518-505-4227
Mailing Address - Fax:
Practice Address - Street 1:1820 MANOR DR APT B
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4612
Practice Address - Country:US
Practice Address - Phone:518-505-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06383000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker