Provider Demographics
NPI:1457661423
Name:NEWSOME, JAMES (MA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N BARNETT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1104
Mailing Address - Country:US
Mailing Address - Phone:814-715-0401
Mailing Address - Fax:
Practice Address - Street 1:70 2ND ST
Practice Address - Street 2:SUIT A
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1556
Practice Address - Country:US
Practice Address - Phone:814-849-2844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional