Provider Demographics
NPI:1821218017
Name:NEWBY, CELESTE (CASAC-T)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:
Last Name:NEWBY
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2706
Mailing Address - Country:US
Mailing Address - Phone:631-369-0104
Mailing Address - Fax:631-369-5433
Practice Address - Street 1:208 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2706
Practice Address - Country:US
Practice Address - Phone:631-369-0104
Practice Address - Fax:631-369-5433
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20909101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)