Provider Demographics
NPI:1790806339
Name:NEWLAND, KATHLEEN LOUISE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LOUISE
Last Name:NEWLAND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 ONAGER CT
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-5602
Mailing Address - Country:US
Mailing Address - Phone:941-474-9171
Mailing Address - Fax:
Practice Address - Street 1:12497 TAMIAMI TRL S
Practice Address - Street 2:SUITE 9
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1447
Practice Address - Country:US
Practice Address - Phone:941-429-0804
Practice Address - Fax:941-429-0814
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010351601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical