Provider Demographics
NPI:1710860150
Name:HARRIS-STEWART, MICHAELA ELIZABETH (RBT)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ELIZABETH
Last Name:HARRIS-STEWART
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 GRAHAM LN E
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-2861
Mailing Address - Country:US
Mailing Address - Phone:270-820-3774
Mailing Address - Fax:
Practice Address - Street 1:2130 GRAHAM LN E
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-2861
Practice Address - Country:US
Practice Address - Phone:270-820-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-25-4532103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral