Provider Demographics
NPI:1376190512
Name:NEWCOMB, CHARLA ANN (MHC)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:ANN
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 S CONTINENTAL DIVIDE RD STE 224
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4251
Mailing Address - Country:US
Mailing Address - Phone:720-402-7787
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:4851 INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6715
Practice Address - Country:US
Practice Address - Phone:303-425-0300
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO0018044101YM0800X
CO0019072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health