Provider Demographics
NPI:1518421270
Name:NEWREN, SAMANTHA LYNNE (RBT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LYNNE
Last Name:NEWREN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1624 MARKET STREET SUITE 226
Mailing Address - Street 2:#16916
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202
Mailing Address - Country:US
Mailing Address - Phone:720-634-2500
Mailing Address - Fax:877-599-0808
Practice Address - Street 1:16060 SAVORY CIR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7724
Practice Address - Country:US
Practice Address - Phone:720-634-2500
Practice Address - Fax:877-599-0808
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-18-74649106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician