Provider Demographics
NPI:1649524703
Name:NEWMAN, LEO JOSEPH (LPC)
Entity type:Individual
Prefix:MR
First Name:LEO
Middle Name:JOSEPH
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 STATE PARK RD
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-1831
Mailing Address - Country:US
Mailing Address - Phone:864-481-0004
Mailing Address - Fax:864-438-5894
Practice Address - Street 1:6715 STATE PARK RD
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1831
Practice Address - Country:US
Practice Address - Phone:864-481-0004
Practice Address - Fax:864-438-5894
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-28
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5740101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional