Tom Steward, P.a. | |
1475 Central Ave Ste 220 Los Alamos NM 87544-4207 | |
(505) 412-0010 | |
Not Available |
Full Name | Tom Steward, P.a. |
---|---|
Speciality | Social Worker |
Location | 1475 Central Ave Ste 220, Los Alamos, New Mexico |
Authorized Official Name and Position | Thomas S. Steward (OWNER) |
Authorized Official Contact | 5054120010 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tom Steward, P.a. 62 Grand Canyon Dr Los Alamos NM 87544-3400 Ph: () - | Tom Steward, P.a. 1475 Central Ave Ste 220 Los Alamos NM 87544-4207 Ph: (505) 412-0010 |
NPI Number | 1255605713 |
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Provider Enumeration Date | 03/01/2012 |
Last Update Date | 03/01/2012 |
Medicare PECOS PAC ID | 1456502806 |
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Medicare Enrollment ID | O20121112000191 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255605713 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 0102111 (New Mexico) | Secondary |
1041C0700X | Social Worker - Clinical | I-3379 (New Mexico) | Primary |
Provider Name | Tom S. Steward |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285784553 PECOS PAC ID: 1456502814 Enrollment ID: I20121112000263 |
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