Provider Demographics
NPI:1558755900
Name:NEWMAN, KRISTA (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 21ST ST
Mailing Address - Street 2:SUITE #232
Mailing Address - City:NEWPORT
Mailing Address - State:MN
Mailing Address - Zip Code:55055
Mailing Address - Country:US
Mailing Address - Phone:651-560-0050
Mailing Address - Fax:951-925-0257
Practice Address - Street 1:24 3RD ST NW
Practice Address - Street 2:UNIT B
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369
Practice Address - Country:US
Practice Address - Phone:651-560-0050
Practice Address - Fax:651-925-0257
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00954101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health