Provider Demographics
NPI:1750949277
Name:NEWMAN, JOHN LEIGHTON JR (LADC, LPCC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LEIGHTON
Last Name:NEWMAN
Suffix:JR
Gender:M
Credentials:LADC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 CRESCENT LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1414
Mailing Address - Country:US
Mailing Address - Phone:507-272-5579
Mailing Address - Fax:
Practice Address - Street 1:602 11TH AVE NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2291
Practice Address - Country:US
Practice Address - Phone:507-272-5579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health