Individual
MR. KENNETH STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
160 PINEHURST AVE STE J, SOUTHERN PINES, NC 28387-7078
(910) 693-7777
(910) 693-1524
Mailing address
1540 PURDUE DRIVE, SUITE 200, FAYETTEVILLE, NC 28303-5510
(910) 693-7777
(910) 693-1524
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C002108
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6002657
—
NC
Enumeration date
10/13/2006
Last updated
07/02/2009
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