person
Mr. Stewart Gregory Tidwell, MA,LMHC
Mental Health Counselor in Fort Wayne, Indiana
NPI 1992935142

Stewart Gregory Tidwell is a Mental Health Counselor based in Fort Wayne, IN and is specialized in Mental Health. Stewart Gregory Tidwell practices in Fort Wayne, IN and has the professional credentials of MA,LMHC. The NPI Number for Stewart Gregory Tidwell is 1992935142 and holds a License No. 39001806A (Indiana).

The current practice location address for Stewart Gregory Tidwell is 2525 Lake Ave, Fort Wayne, IN and can be reached out via phone at 260-484-4153.

Location: 2525 Lake Ave, Fort Wayne, IN, 46805-5407
person
Provider Profile Details
NPI Number
1992935142
Provider Name
Stewart Gregory Tidwell
Credential
MA,LMHC
Provider Entity Type
Individual
Gender
Male
Address
2525 Lake Ave, Fort Wayne, IN, 46805-5407
Phone Number
260-484-4153
Fax Number
Provider Enumeration Date
07/22/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2525 Lake Ave
City
State
Zip
46805-5407
Phone Number
260-484-4153
Fax Number
person
Provider Business Mailing Address Details
Address
2525 Lake Ave
City
State
Zip
46805-5407
Phone Number
260-484-4153
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
39001806A (Indiana)
Definition
Definition to come...
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