Provider Demographics
NPI:1689744302
Name:STEWART STEVENS, EMILY (PSYD, MA)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:STEWART STEVENS
Suffix:
Gender:F
Credentials:PSYD, MA
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1 FORD PL STE 3A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:313-744-8068
Mailing Address - Fax:
Practice Address - Street 1:1201 E MICHIGAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1855
Practice Address - Country:US
Practice Address - Phone:517-204-4841
Practice Address - Fax:517-205-5956
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361004766103TC1900X
MI6351004721103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth