Provider Demographics
NPI:1972042455
Name:NEWMAN, DANIELLE (LMHC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 S ROOSEVELT ROAD AD
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-9548
Mailing Address - Country:US
Mailing Address - Phone:575-760-0754
Mailing Address - Fax:
Practice Address - Street 1:3017 N PRINCE ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-3804
Practice Address - Country:US
Practice Address - Phone:575-760-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0180711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health