Provider Demographics
NPI:1659942605
Name:NEWBY, BRIAN (PHD, LMSW, CAADC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:NEWBY
Suffix:
Gender:M
Credentials:PHD, LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GRAND CANYON CT
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1784
Mailing Address - Country:US
Mailing Address - Phone:302-750-6730
Mailing Address - Fax:
Practice Address - Street 1:2644 CAPITOL TRL STE 250
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7231
Practice Address - Country:US
Practice Address - Phone:302-683-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0010692104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker