Provider Demographics
NPI:1073658241
Name:NEWELL, CHARLES I (LCPC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:I
Last Name:NEWELL
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20495
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-0495
Mailing Address - Country:US
Mailing Address - Phone:406-259-6161
Mailing Address - Fax:406-259-5588
Practice Address - Street 1:1004 DIVISION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6030
Practice Address - Country:US
Practice Address - Phone:406-259-6161
Practice Address - Fax:406-259-5588
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1170 LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0256615Medicaid
MT000742090OtherBCBS