Nathaniel Stewart Jr., M.A., L.P.

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

LP2279 Issued in MN

Practice address

1535 Laurel Ave
Saint Paul, MN 55104-6739

Phone

(651) 645-0645

Fax

(651) 645-0630

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychology & Rehabilitation Services, LTD

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1740417757
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225199052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LAUREL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046739",
            "telephone_number": "651-645-0645",
            "fax_number": "651-645-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LAUREL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046739",
            "telephone_number": "651-645-0645",
            "fax_number": "651-645-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.A., L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MN",
            "license": "LP2279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "62-73761",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86656ST",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "111770",
            "identifier": "UCARE MN",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cylena Jean Stewart
• David Dickson Stewart, PH.D.
• Jennifer Stewart, MSW, LICSW
• Jessica Stewart, CNP
• Leslie Anne Stewart, D.C.
• Patricia M Stewart, DO
• Shannon Stewart
• Theresa Ann Stewart, RN
• Joan Steyermark, M.S., C.G.C.
• Ronika Darlene Stibbins, MSW, LICSW

• Group Psychotherapy Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Group Psychotherapy Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.