Provider Demographics
NPI:1205229168
Name:NEWMAN, CAROLYN EAGLES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:EAGLES
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:EAGLES
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:605 TWINRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5268
Mailing Address - Country:US
Mailing Address - Phone:804-240-6546
Mailing Address - Fax:
Practice Address - Street 1:605 TWINRIDGE LN
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5268
Practice Address - Country:US
Practice Address - Phone:804-240-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040004621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical