Provider Demographics
NPI:1760099493
Name:NEWMAN, GABRIELLE SUSANNE (LPC-IT)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:SUSANNE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 CLUB CIR APT 201S
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-6996
Mailing Address - Country:US
Mailing Address - Phone:920-562-4974
Mailing Address - Fax:
Practice Address - Street 1:8825 S HOWELL AVE
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-3760
Practice Address - Country:US
Practice Address - Phone:414-367-6257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)