Provider Demographics
NPI:1356682918
Name:NEWPOL PSYCHOLOGICAL SERVICES PLLC
Entity type:Organization
Organization Name:NEWPOL PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST AND OWNER OF PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NEWPOL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:734-355-8216
Mailing Address - Street 1:4036 DAUNTLESS LANE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412
Mailing Address - Country:US
Mailing Address - Phone:734-355-8216
Mailing Address - Fax:
Practice Address - Street 1:2301 PACKARD ST FL 2
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6321
Practice Address - Country:US
Practice Address - Phone:734-355-8216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012502103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI6698OtherMEDICARE GROUP PTAN
MIMI6698Medicare UPIN