Provider Demographics
NPI:1518996164
Name:NEWMAN, NEAL (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S CASSADY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1714
Mailing Address - Country:US
Mailing Address - Phone:614-239-1083
Mailing Address - Fax:614-688-3440
Practice Address - Street 1:150 S CASSADY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-1714
Practice Address - Country:US
Practice Address - Phone:614-239-1083
Practice Address - Fax:614-688-3440
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2020103TC1900X, 103TE1100X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNECP23381Medicare ID - Type Unspecified