Provider Demographics
NPI:1255862355
Name:NEWTON, JAMIAN (MS, LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:JAMIAN
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:MS, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 FULTON PL
Mailing Address - Street 2:APT 2A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2424
Mailing Address - Country:US
Mailing Address - Phone:804-832-1138
Mailing Address - Fax:
Practice Address - Street 1:5603B NEW GARDEN VILLAGE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8595
Practice Address - Country:US
Practice Address - Phone:336-272-8090
Practice Address - Fax:336-272-0094
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health