Provider Demographics
NPI:1558628834
Name:NEWSOM, ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1771 INTERNATIONAL PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-1865
Mailing Address - Country:US
Mailing Address - Phone:972-696-9359
Mailing Address - Fax:844-828-3612
Practice Address - Street 1:1771 INTERNATIONAL PKWY STE 107
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1865
Practice Address - Country:US
Practice Address - Phone:972-696-9539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW207261041C0700X
AR12281-C1041C0700X
IL149.0249661041C0700X
TX523521041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149.024966OtherLCSW
AR12281-COtherLCSW
FLSW20726OtherLCSW
TX52352OtherLCSW-S