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NPI Code Detail

MEDICARE: ELIZABETH NEWSOM LCSW

MEDICARE: ELIZABETH NEWSOM LCSW
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
11041C0700XClinical Social Worker12281-CAR
21041C0700XClinical Social WorkerSW20726FL
31041C0700XClinical Social Worker149.024966IL
41041C0700XClinical Social Worker52352TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112281-COTHERARLCSW
2SW20726OTHERFLLCSW
3149.024966OTHERILLCSW
452352OTHERTXLCSW-S

General Provider Information

NPI Number : 1558628834
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH NEWSOM LCSW
Provider Business Mailing Address
First Line : 1771 INTERNATIONAL PKWY STE 107
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-1865
Country : US
Telephone Number : 972-696-9359
Fax Number : 844-828-3612
Provider Business Practice Location Address
First Line : 1771 INTERNATIONAL PKWY STE 107
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-1865
Country : US
Telephone Number : 972-696-9539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2012
Last Update Date : 07/12/2024

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Directions to “ ELIZABETH NEWSOM LCSW” Practice Location

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