Provider Demographics
NPI:1134830227
Name:NEWTON, TIMOTHY
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:CASNOVIA
Mailing Address - State:MI
Mailing Address - Zip Code:49318-5106
Mailing Address - Country:US
Mailing Address - Phone:616-210-0972
Mailing Address - Fax:
Practice Address - Street 1:115 GRAND ST
Practice Address - Street 2:
Practice Address - City:CASNOVIA
Practice Address - State:MI
Practice Address - Zip Code:49318-5106
Practice Address - Country:US
Practice Address - Phone:616-210-0972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No104100000XBehavioral Health & Social Service ProvidersSocial Worker