Basic Information
Provider Information
NPI: 1861841876
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEWMAN
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2707 BROWNS LN
Address2:  
City: JONESBORO
State: AR
PostalCode: 724017213
CountryCode: US
TelephoneNumber: 8709724961
FaxNumber:  
Practice Location
Address1: 2707 BROWNS LN
Address2:  
City: JONESBORO
State: AR
PostalCode: 724017213
CountryCode: US
TelephoneNumber: 8709724961
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/09/2016
LastUpdateDate: 05/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X7066TNN193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersSocial WorkerClinical
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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