Provider Demographics
NPI:1972123883
Name:ELIZABETH NEWTON, PSYD AND ASSOC INC
Entity Type:Organization
Organization Name:ELIZABETH NEWTON, PSYD AND ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:404-653-1117
Mailing Address - Street 1:1827 POWERS FERRY RD
Mailing Address - Street 2:BLDG 21
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339
Mailing Address - Country:US
Mailing Address - Phone:404-653-1117
Mailing Address - Fax:404-880-0133
Practice Address - Street 1:1827 POWERS FERRY RD
Practice Address - Street 2:BLDG 21
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:404-653-1117
Practice Address - Fax:404-880-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1801137690OtherNPI
GA003132009GMedicaid