Provider Demographics
NPI:1659965135
Name:NEWMAN, AUDREY ABIGAIL (MS)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:ABIGAIL
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:ABIGAIL
Other - Last Name:NAPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2025 N MAGNOLIA AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-7273
Mailing Address - Country:US
Mailing Address - Phone:678-481-5557
Mailing Address - Fax:
Practice Address - Street 1:3166 N LINCOLN AVE STE 224
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3119
Practice Address - Country:US
Practice Address - Phone:773-622-6218
Practice Address - Fax:708-622-7440
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional