Provider Demographics
NPI:1407161094
Name:NEWBURN, EMILY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:NEWBURN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 HIGH ST
Mailing Address - Street 2:SUIT 307
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3820
Mailing Address - Country:US
Mailing Address - Phone:207-317-7114
Mailing Address - Fax:
Practice Address - Street 1:95 HIGH ST
Practice Address - Street 2:SUIT 307
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3820
Practice Address - Country:US
Practice Address - Phone:207-317-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC136451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical