Provider Demographics
NPI:1831510783
Name:NEWMAN, KACIE (LMSW)
Entity type:Individual
Prefix:
First Name:KACIE
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KACIE
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1450 NW 114TH ST
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-7039
Mailing Address - Country:US
Mailing Address - Phone:515-553-6200
Mailing Address - Fax:
Practice Address - Street 1:1450 NW 114TH ST
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7039
Practice Address - Country:US
Practice Address - Phone:515-553-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor