Provider Demographics
NPI:1518100338
Name:NEWSOME, JOAN CATHERINE PAYNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:CATHERINE PAYNE
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 KITTENSETT CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-5437
Mailing Address - Country:US
Mailing Address - Phone:919-622-7975
Mailing Address - Fax:
Practice Address - Street 1:5602 KITTENSETT CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-5437
Practice Address - Country:US
Practice Address - Phone:919-622-7975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist