Provider Demographics
NPI:1437422276
Name:NEWKIRK, CAROLE WELLING (MA, LMHC, NCC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:WELLING
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:MA, LMHC, NCC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W SADIE ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-4440
Mailing Address - Country:US
Mailing Address - Phone:813-438-5949
Mailing Address - Fax:813-438-5951
Practice Address - Street 1:306 W SADIE ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4440
Practice Address - Country:US
Practice Address - Phone:813-438-5949
Practice Address - Fax:813-438-5951
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH5967OtherSTATE OF FLORIDA