Provider Demographics
NPI:1427394519
Name:NEWMAN, MAC (CMHC, AAP)
Entity Type:Individual
Prefix:
First Name:MAC
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:CMHC, AAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101-1227
Mailing Address - Country:US
Mailing Address - Phone:413-519-9564
Mailing Address - Fax:
Practice Address - Street 1:254 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-2001
Practice Address - Country:US
Practice Address - Phone:603-298-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104340101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)