Healthcare Provider Details

I. General information

NPI: 1104080134
Provider Name (Legal Business Name): DENISE LAUREL NEWMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 S CARROLLTON AVE
NEW ORLEANS LA
70119-6025
US

IV. Provider business mailing address

4616 S CARROLLTON AVE
NEW ORLEANS LA
70119-6025
US

V. Phone/Fax

Practice location:
  • Phone: 504-482-1412
  • Fax: 504-482-2615
Mailing address:
  • Phone: 504-482-1412
  • Fax: 504-482-2615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number081000312
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1044
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: