Provider Demographics
NPI:1144422957
Name:NEWBOLD, EMILY KATHERINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHERINE
Last Name:NEWBOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E 4800 S STE 120C
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5557
Mailing Address - Country:US
Mailing Address - Phone:801-899-6797
Mailing Address - Fax:801-446-3999
Practice Address - Street 1:825 E 4800 S STE 120C
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5557
Practice Address - Country:US
Practice Address - Phone:801-899-6797
Practice Address - Fax:801-446-3999
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6619149-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1144422957OtherNPI