Individual provider Active NPI

Cyrus Shephard Stewart, PHD

  • Marriage & Family Therapist
  • East Lansing, MI
National Provider Identifier
1417079302
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101005059 Issued in MI
Practice address
5031 Park Lake Road
Meridian Professional Psychological Consultants
East Lansing, MI 48823-3835
Phone
(517) 332-0811
Fax
(517) 332-4452
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801017511 MI
Marriage & Family Therapist 106H00000X 4101005059 MI Primary

Addresses

Primary practice location

5031 Park Lake Road
Meridian Professional Psychological Consultants
East Lansing, MI 48823-3835

Mailing address

5031 Park Lake Road
Meridian Professional Psychological Consultants
East Lansing, MI 48823-3835
Phone (517) 332-0811

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6801017511MIMDSocial Worker
4101005059MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Professional Psychological Consultants PastSince Feb 1, 2013 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417079302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5031 PARK LAKE ROAD",
            "address_2": "MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233835",
            "telephone_number": "517-332-0811",
            "fax_number": "517-332-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 PARK LAKE ROAD",
            "address_2": "MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233835",
            "telephone_number": "517-332-0811",
            "fax_number": "517-332-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CYRUS",
        "middle_name": "SHEPHARD",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801017511",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.