Provider Demographics
NPI:1740578392
Name:NEWELL, ABIGAEL MARY CARMEN (MFT)
Entity Type:Individual
Prefix:
First Name:ABIGAEL
Middle Name:MARY CARMEN
Last Name:NEWELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81557 DR CARREON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5517
Mailing Address - Country:US
Mailing Address - Phone:760-391-6999
Mailing Address - Fax:
Practice Address - Street 1:81557 DR CARREON BLVD
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5517
Practice Address - Country:US
Practice Address - Phone:760-391-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA105169106H00000X
CA77856106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator