Provider Demographics
NPI:1629044250
Name:LINDA NEWSOME LCSW & ASSOCIATES PA
Entity Type:Organization
Organization Name:LINDA NEWSOME LCSW & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-PROFESSIONAL DATA MANAGME
Authorized Official - Prefix:
Authorized Official - First Name:MITCH
Authorized Official - Middle Name:
Authorized Official - Last Name:IVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-751-9120
Mailing Address - Street 1:2501 B WAYNE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9436
Mailing Address - Country:US
Mailing Address - Phone:919-739-9992
Mailing Address - Fax:919-739-9993
Practice Address - Street 1:403 AIRLE PLACE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9436
Practice Address - Country:US
Practice Address - Phone:919-739-9992
Practice Address - Fax:919-739-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC200179438001OtherCHAMPUS
NC6005228Medicaid
NC016N4OtherBCBS
NC6005226Medicaid
NC6005226Medicaid
NC2336437Medicare PIN