Provider Demographics
NPI:1588036149
Name:NEWELL, NAKITA
Entity Type:Individual
Prefix:
First Name:NAKITA
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 EE WALLACE BLVD S
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-3224
Mailing Address - Country:US
Mailing Address - Phone:318-757-9363
Mailing Address - Fax:
Practice Address - Street 1:615 EE WALLACE BLVD S
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-3224
Practice Address - Country:US
Practice Address - Phone:936-331-8757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health