Provider Demographics
NPI:1659745099
Name:STEWART, THURMA (LMFT)
Entity type:Individual
Prefix:
First Name:THURMA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 N MOUNTAIN AVE # 216
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5016
Mailing Address - Country:US
Mailing Address - Phone:909-401-1759
Mailing Address - Fax:
Practice Address - Street 1:517 N MOUNTAIN AVE # 216
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5016
Practice Address - Country:US
Practice Address - Phone:909-401-1759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
103TF0200X, 101YM0800X
CA149740106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health