Provider Demographics
NPI:1427574227
Name:NEWMAN, KATELYN (LCSW)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:NEWMAN
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 1:10151 DORRELL LN UNIT 2005
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1037
Mailing Address - Country:US
Mailing Address - Phone:702-556-7291
Mailing Address - Fax:
Practice Address - Street 1:4250 E BONANZA RD STE 17
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-6105
Practice Address - Country:US
Practice Address - Phone:702-331-4277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor