Individual
DEIDRA SHANTE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW
Contact information
Practice address
112B BOLT DR, LAURENS, SC 29360-1900
(864) 681-3798
Mailing address
PO BOX 1543, LAURENS, SC 29360-1543
(864) 681-3798
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW.9621 CP
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1041
—
SC
Enumeration date
12/01/2009
Last updated
03/28/2013
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