Individual provider Active NPI

Tonja M Stewart, LPC

  • Professional Counselor
  • Roanoke, VA
National Provider Identifier
1033349162
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004646 Issued in VA
Practice address
1402 Grandin Rd SW
Suite 209
Roanoke, VA 24015-2345
Phone
(540) 206-2330
Fax
(540) 206-2330
NPI assigned
Jul 23, 2009
Last updated
Sep 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701004646 VA Primary

Addresses

Primary practice location

1402 Grandin Rd SW
Suite 209
Roanoke, VA 24015-2345

Mailing address

1402 Grandin Rd SW
Suite 209
Roanoke, VA 24015-2345
Phone (540) 206-2330

Other identifiers 1

IdentifierTypeStateIssuer
1033349162MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701004646VAMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1033349162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 GRANDIN RD SW",
            "address_2": "SUITE 209",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240152345",
            "telephone_number": "540-206-2330",
            "fax_number": "540-206-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 GRANDIN RD SW",
            "address_2": "SUITE 209",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240152345",
            "telephone_number": "540-206-2330",
            "fax_number": "540-206-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TONJA",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033349162",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.