Provider Demographics
NPI:1558590075
Name:NEWMAN, JESSICA BETH (MA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:BETH
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CEDAR ST # 3
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-3521
Mailing Address - Country:US
Mailing Address - Phone:617-230-6320
Mailing Address - Fax:
Practice Address - Street 1:204 CEDAR ST # 3
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-3521
Practice Address - Country:US
Practice Address - Phone:617-230-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health