Provider Demographics
NPI:1780218875
Name:STEWART, CHENEL MARIE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:CHENEL
Middle Name:MARIE
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 HOUSTON RD STE 29
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4879
Mailing Address - Country:US
Mailing Address - Phone:859-746-9272
Mailing Address - Fax:
Practice Address - Street 1:7000 HOUSTON RD STE 29
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4879
Practice Address - Country:US
Practice Address - Phone:859-746-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY270931Medicaid