Provider Demographics
NPI:1922885276
Name:NEWENS, LOGAN (ADC, LPCC)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:NEWENS
Suffix:
Gender:F
Credentials:ADC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5302
Mailing Address - Country:US
Mailing Address - Phone:720-600-6309
Mailing Address - Fax:
Practice Address - Street 1:709 3RD AVE STE 301
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5926
Practice Address - Country:US
Practice Address - Phone:720-600-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002006101YA0400X, 101YM0800X
ACD.0002006101YA0400X
COLPCC.0019888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)