Basic Information
Provider Information
NPI: 1245471465
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEWMAN
FirstName: BARBARA
MiddleName: S
NamePrefix: MS.
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3511 W. COMMERCIAL BLVD.
Address2: STE. 305
City: FT. LAUDERDALE
State: FL
PostalCode: 333093322
CountryCode: US
TelephoneNumber: 9547279498
FaxNumber: 9547334483
Practice Location
Address1: 3511 W COMMERCIAL BLVD
Address2: STE. 305
City: FT LAUDERDALE
State: FL
PostalCode: 333093331
CountryCode: US
TelephoneNumber: 9547279498
FaxNumber: 9547334483
Other Information
ProviderEnumerationDate: 03/18/2009
LastUpdateDate: 03/18/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
172V00000XMH3203FLY Other Service ProvidersCommunity Health Worker 

No ID Information.


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