Provider Demographics
NPI:1245936780
Name:NEWMAN, SANDI MICHELE (LAC AND LMSW)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:MICHELE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LAC AND LMSW
Other - Prefix:MS
Other - First Name:SANDI
Other - Middle Name:MICHELE
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, LMSW
Mailing Address - Street 1:235 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3222 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6252
Practice Address - Country:US
Practice Address - Phone:504-418-2296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5128101YA0400X
LA17838104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA34563321Medicaid