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DR. DELARIOUS ONEAL STEWART EDD, NCSP, NCC, LPC

School >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1982914628

Individual Registrant:
DR. DELARIOUS ONEAL STEWART EDD, NCSP, NCC, LPC
Gender: M
Sole Proprietor

Location and contact information for practice:
404 MARKET ST  PORT GIBSON, MS 39150 US
Tel: 601-437-4232  Fax: 601-437-4409

Contact information for business:
PO BOX 580082  PLEASANT PRAIRIE, WI 53182 US
Tel: 601-867-1914  Fax: 601-437-4409

Registration Information:
NPI: 1982914628
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TS0200XBehavioral Health & Social Service Providers
Psychologist
School
MS200902
N103TS0200XBehavioral Health & Social Service Providers
Psychologist
LAAN 475286
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
WI5230-125

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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