Healthcare Provider Details

I. General information

NPI: 1134343502
Provider Name (Legal Business Name): JAMES DAVID NEWCOMB LPC , CAC III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 KENDALL ST
LAKEWOOD CO
80214-1412
US

IV. Provider business mailing address

4853 IDEPENDENCE STREET SUITE 200
WHEATRIDGE CO
80033-6715
US

V. Phone/Fax

Practice location:
  • Phone: 720-544-2088
  • Fax: 303-232-4392
Mailing address:
  • Phone: 303-425-0300
  • Fax: 303-432-5071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3916
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: