KYMRA FOWLER STEWART (NPI# 1053348177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053348177 |
| Entity Type | Individual |
| Full Name | KYMRA FOWLER STEWART |
| Credential | LCSW |
| Practice Address |
3960 Executive Park Blvd Ste 3 Southport NC 28461 |
| Mailing Address |
3960 Executive Park Blvd Ste 3 Southport NC 28461-8184 |
| Practice Telephone | 9108540371 |
| Practice Fax Number | 9108540371 |
| Mailing Telephone | 9108540371 |
| Mailing Fax Number | 9108540371 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2018-10-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C001484 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6002012 | 05 | |
| NC | BCBS NC | 79895 | 01 |
| NC | BCBS | 79895 | 01 |
| NC | MEDICAID | 6002012 | 01 |
| Street Address |
3960 EXECUTIVE PARK BLVD STE 3 |
| City | SOUTHPORT |
| State | NC |
| Zip Code | 28461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942776943 | Southport Counseling Services, Pllc | Social Worker | 3960 Executive Park Blvd Ste 3, Southport, NC 28461-8184 | 2018-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645542 | Island Time Medical and Wellness, Pllc | Clinic/Center | 39 Dowitcher Trl, Bald Head Island, NC 28461 | 2020-09-30 |
| 1871095356 | Sunny Point Fire & Rescue | Emergency Medicine | 6280 Sunny Point Rd Bldg 44, Southport, NC 28461 | 2018-03-01 |
| 1962882035 | Kimberlee Kreuzer | Physical Therapist | 1517 N Howe St Suite 4, Southport, NC 28461 | 2015-06-04 |
| 1134449291 | Kristos Nektarios Vaughan | Family Medicine | 3009 Medical Plaza Lane, Southport, NC 28461 | 2010-06-10 |
| 1750612974 | Melissa Holden | Nurse Practitioner | 1517 N Howe St Ste 12, Southport, NC 28461 | 2010-01-28 |
| 1437315165 | North Carolina Shoulder and Elbow Surgery and Sports Medicine | Orthopaedic Surgery | 900 North Howe St, Southport, NC 28461 | 2008-08-01 |
| 1124212329 | Edward Frank Babel | Nurse Practitioner | 201 West Boiling Spring Lakes Road, New Hope Clinic, Boiling Spring Lakes, NC 28461 | 2007-08-30 |
| 1952453151 | Robert Wayne Poe | Otolaryngology | 900 N. Howe St, Southport, NC 28461 | 2007-01-17 |
| 1275640898 | Kurt Thomas Scheetz | Dentist | 1301 N Howe Street, Southport, NC 28461 | 2006-08-23 |
| 1396859872 | Brunswick Family Medicine Pa | Family Medicine | 3960 Executive Park Blvd, Unit 600, Southport, NC 28461 | 2006-08-19 |
| Find all providers in zip 28461 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083232631 | Shannon A Perez | Social Worker | 70 High Point Rd, Southport, NC 28461-9757 | 2020-07-09 |
| 1205389954 | Elizabeth Perry | Social Worker | 239 Barberry Rd, Southport, CT 06890-3035 | 2016-07-29 |
| 1992070122 | Charlene D Irvin | Social Worker | 4006 Norseman Loop, Unit 2, Southport, NC 28461-8234 | 2012-03-21 |
| 1760786867 | Jean Gabriel | Social Worker | 3557 Sanderling Dr Se, Southport, NC 28461-8576 | 2011-01-04 |
| 1114154317 | Ruth Deaton Posey | Social Worker | 4146 Long Beach Rd Se Ste C, Southport, NC 28461-7472 | 2009-06-15 |
| 1316140841 | Carolyn Gale Pryor | Social Worker | 5900 Dutchman Creek Rd, Southport, NC 28461-2943 | 2007-06-11 |
| 1891328225 | Ann Margaret Sandercox | Social Worker | 2960 Post Rd Fl 3, Southport, CT 06890-1268 | 2020-02-13 |
| 1518598754 | Krista Amato | Social Worker | 2960 Post Rd Ste 3b2, Southport, CT 06890-1268 | 2020-01-27 |
| 1760043590 | John Gleason Jr. | Social Worker | 2960 Post Rd, Southport, CT 06890-1268 | 2019-06-24 |
| 1942776943 | Southport Counseling Services, Pllc | Social Worker | 3960 Executive Park Blvd Ste 3, Southport, NC 28461-8184 | 2018-10-17 |
| Find all providers in SOUTHPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.