Provider Demographics
NPI:1811663909
Name:NEWTON, BRENDA (MA, LMHP, NCC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MA, LMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 N 51ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1844
Mailing Address - Country:US
Mailing Address - Phone:712-560-2442
Mailing Address - Fax:
Practice Address - Street 1:5306 N 51ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1844
Practice Address - Country:US
Practice Address - Phone:712-560-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health