Provider Demographics
NPI:1346561016
Name:NEWTON, TIFFANY SOPHIA (LCAS)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SOPHIA
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-5221
Mailing Address - Country:US
Mailing Address - Phone:910-995-3045
Mailing Address - Fax:910-817-9845
Practice Address - Street 1:109 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-5221
Practice Address - Country:US
Practice Address - Phone:910-995-3045
Practice Address - Fax:910-817-9845
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15554101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor