Provider Demographics
NPI:1376584813
Name:NEWMAN, JOSEPH EWELL (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:EWELL
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 RIVERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2811
Mailing Address - Country:US
Mailing Address - Phone:936-531-6300
Mailing Address - Fax:
Practice Address - Street 1:1020 RIVERWOOD CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2811
Practice Address - Country:US
Practice Address - Phone:936-531-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151831041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168194203Medicaid
TX168194203Medicaid
TX8D6135Medicare PIN