Provider Demographics
NPI:1457402893
Name:NEWTON, KIMBERLY ANN (LPE-I)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANN
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LPE-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 SAINT CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3467
Mailing Address - Country:US
Mailing Address - Phone:501-258-5461
Mailing Address - Fax:501-955-5531
Practice Address - Street 1:4107 RICHARDS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2653
Practice Address - Country:US
Practice Address - Phone:501-955-2220
Practice Address - Fax:501-955-5531
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR01-4E101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health