Healthcare Provider Details

I. General information

NPI: 1396146205
Provider Name (Legal Business Name): JOHN F NEWTON LPC, LISAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 09/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E. EARLL DR. SUITE 200
PHOENIX AZ
85012-2647
US

IV. Provider business mailing address

202 E. EARLL DR. SUITE 200
PHOENIX AZ
85012-2647
US

V. Phone/Fax

Practice location:
  • Phone: 480-201-4540
  • Fax: 602-599-5711
Mailing address:
  • Phone: 602-808-2800
  • Fax: 602-599-5711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-10638
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: