Provider Demographics
NPI:1356681621
Name:NEWMAN, JOHN HAROLD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HAROLD
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1905
Mailing Address - Country:US
Mailing Address - Phone:248-524-8850
Mailing Address - Fax:
Practice Address - Street 1:1225 E BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1905
Practice Address - Country:US
Practice Address - Phone:248-524-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010165471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801016547OtherBOARD OF SOCIAL WORK, MASTER'S SOCIAL WORK - CLINICAL AND MACRO
MI80-08923040OtherBCBS OF MICHIGAN
MI80-08923040OtherBCBS OF MICHIGAN