Provider Demographics
NPI:1891762290
Name:NEWMAN, MARTA VICTORIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARTA
Middle Name:VICTORIA
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MARTA
Other - Middle Name:VICTORIA
Other - Last Name:MCKENNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:6340 E PLACITA BECAL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1256
Mailing Address - Country:US
Mailing Address - Phone:520-202-1818
Mailing Address - Fax:520-202-1718
Practice Address - Street 1:127 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-2005
Practice Address - Country:US
Practice Address - Phone:520-202-1818
Practice Address - Fax:520-202-1718
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10190101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ751158Medicaid