Provider Demographics
NPI:1548314453
Name:STEWART, BRIAN (LICSW)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:STEWART
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 E SHEFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1448
Mailing Address - Country:US
Mailing Address - Phone:413-582-6550
Mailing Address - Fax:413-528-6585
Practice Address - Street 1:78 STATE RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1363
Practice Address - Country:US
Practice Address - Phone:413-528-6550
Practice Address - Fax:413-528-6585
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1136861041C0700X
NY0754981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical