Provider Demographics
NPI:1295846780
Name:NEWTON, NANCY JORDAN(JODY) (MSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JORDAN(JODY)
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BOSTON POST RD E
Mailing Address - Street 2:SUITE 450
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3527
Mailing Address - Country:US
Mailing Address - Phone:508-460-9633
Mailing Address - Fax:508-481-2609
Practice Address - Street 1:221 BOSTON POST RD E
Practice Address - Street 2:SUITE 450
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3527
Practice Address - Country:US
Practice Address - Phone:508-460-9633
Practice Address - Fax:508-481-2609
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1052311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP03712Medicare ID - Type UnspecifiedMEDICARE B PROVIDER ID