Provider Demographics
NPI:1609619527
Name:STUART, NANCY L
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:STUART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CEDAR MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4533
Mailing Address - Country:US
Mailing Address - Phone:540-486-3534
Mailing Address - Fax:
Practice Address - Street 1:131 CEDAR MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-4533
Practice Address - Country:US
Practice Address - Phone:540-486-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11656903101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor