Provider Demographics
NPI:1982840062
Name:NEWBERG, LENITA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LENITA
Middle Name:
Last Name:NEWBERG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 LADUE ROAD
Mailing Address - Street 2:SUITE #312
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2079
Mailing Address - Country:US
Mailing Address - Phone:314-754-3251
Mailing Address - Fax:314-446-3051
Practice Address - Street 1:8820 LADUE ROAD
Practice Address - Street 2:SUITE #312
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2079
Practice Address - Country:US
Practice Address - Phone:314-754-3251
Practice Address - Fax:314-446-3051
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
MO0026201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical