Provider Demographics
NPI:1659873917
Name:NEWTON, MEGAN KELLY
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KELLY
Last Name:NEWTON
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:PO BOX 332
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:CO
Mailing Address - Zip Code:80809-0332
Mailing Address - Country:US
Mailing Address - Phone:562-480-3009
Mailing Address - Fax:
Practice Address - Street 1:2790 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5337
Practice Address - Country:US
Practice Address - Phone:719-203-4370
Practice Address - Fax:719-399-4277
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-22-59016103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst