Individual
JAY R STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, PCC-S, LICDC
Contact information
Practice address
3425 EXECUTIVE PKWY, SUITE 230, TOLEDO, OH 43606-1326
(419) 531-3500
(419) 531-3500
Mailing address
3425 EXECUTIVE PKWY OH 4360, SUITE 230, TOLEDO, OH 43606-1326
(419) 531-3500
(419) 531-3500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E1319
OHIO COUNSELOR LICENSE
OH
Enumeration date
02/12/2010
Last updated
05/09/2011
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