Individual provider · Type 1 NPI

Stewart Gregory Tidwell, MA, LMHC

Mental Health Counselor · Fort Wayne, IN

NPI number 1992935142 Active

Practice location

2525 Lake Ave
Fort Wayne, IN 46805-5407

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X39001806A (IN)

Mental Health Counselor: Definition to come...

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About NPI 1992935142

Stewart Gregory Tidwell, MA, LMHC's National Provider Identifier is 1992935142, issued on Jul 22, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 22, 2009.