MEDICARE: MS. ERIN E NEWMAN LICSW, LADC I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	112074	MA

General Provider Information

NPI Number	:	1114095288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN E NEWMAN LICSW, LADC I

Provider Business Mailing Address
First Line	:	151 MERRIMAC ST FL 6
Second Line	:	DEPARTMENT OF PSYCHIATRY-ARMS
City	:	BOSTON
State	:	MA
Zip	:	02114-4714
Country	:	US
Telephone Number	:	617-643-4695
Fax Number	:	617-643-7667

Provider Business Practice Location Address
First Line	:	151 MERRIMAC ST FL 6
Second Line	:	DEPARTMENT OF PSYCHIATRY-ARMS
City	:	BOSTON
State	:	MA
Zip	:	02114-4714
Country	:	US
Telephone Number	:	617-643-4695
Fax Number	:	617-643-7667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	02/02/2011

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