Provider Demographics
NPI:1629347976
Name:NEWTOWN COUNSELING AND EVALUATION SERVICES LLC
Entity Type:Organization
Organization Name:NEWTOWN COUNSELING AND EVALUATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:ATTRYDE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:1267-249-3318
Mailing Address - Street 1:4 TERRY DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1838
Mailing Address - Country:US
Mailing Address - Phone:267-249-3318
Mailing Address - Fax:
Practice Address - Street 1:4 TERRY DR
Practice Address - Street 2:SUITE 11
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:267-249-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000888101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102613827Medicaid