Provider Demographics
NPI:1861004863
Name:STEWART, KEVIN SEAN (LAC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:SEAN
Last Name:STEWART
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2037 OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5844
Mailing Address - Country:US
Mailing Address - Phone:406-782-4417
Mailing Address - Fax:
Practice Address - Street 1:22 W PARK ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1714
Practice Address - Country:US
Practice Address - Phone:406-565-5484
Practice Address - Fax:406-565-5485
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC-LIC-1961101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)