Provider Demographics
NPI:1548577133
Name:NEWBAKER, SHELIA (LCSW, CMHT)
Entity Type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:
Last Name:NEWBAKER
Suffix:
Gender:F
Credentials:LCSW, CMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4128
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39304-4128
Mailing Address - Country:US
Mailing Address - Phone:601-581-7562
Mailing Address - Fax:601-581-7676
Practice Address - Street 1:5701 N HILLS ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-2903
Practice Address - Country:US
Practice Address - Phone:601-581-7562
Practice Address - Fax:601-581-7676
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC4729104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker