Jada Jerusha Stewart-Willis, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9818 Issued in FL

Practice address

10000 Bay Pines Blvd
Bay Pines, FL 33744-8200

Phone

(727) 398-6661

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jada J. Stewart Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1699204594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 6TH AVE N APT 7",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337012430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART-WILLIS",
        "first_name": "JADA",
        "middle_name": "JERUSHA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADA",
            "last_name": "STEWART",
            "middle_name": "J.",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Richard Steele Jr., PHARM.D.
• Clarice Rae Steiner, RD, LD/N, CNSD
• Carolyn Kelly Stephens, PHARM.D.
• Joe Stephens, D. MIN, M. DIV.
• Jason Corbin Steward, PH.D.
• Jonathan Taylor Stewart, MD
• Robert David Stewart, PHARMD
• Andrea Eileen Story-Hilding, MSW
• Victoria Suarez
• Marina Sulik, PHARMD

• Clinical Psychologist in Bay Pines, FL
• Providers in Bay Pines, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; 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.