Provider Demographics
NPI:1154463883
Name:NEWMAN, BEVERLY J (MA, LPC, LSSP, RPT)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MA, LPC, LSSP, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 BEACONSHIRE ROAD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3867
Mailing Address - Country:US
Mailing Address - Phone:713-826-1381
Mailing Address - Fax:281-498-4761
Practice Address - Street 1:738 HIGHWAY 6 S
Practice Address - Street 2:STE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4015
Practice Address - Country:US
Practice Address - Phone:713-826-1381
Practice Address - Fax:281-870-9009
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180933702Medicaid
TX180933701Medicaid