Provider Demographics
NPI:1093264749
Name:NEWVILLE, HOWARD (PHD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:NEWVILLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 NE 45TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1107 NE 45TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4690
Practice Address - Country:US
Practice Address - Phone:206-616-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021589103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)