Healthcare Provider Details

I. General information

NPI: 1750192563
Provider Name (Legal Business Name): LAURA NICOLE NEWCOMB LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 BEACON ST STE 204
BROOKLINE MA
02446-5622
US

IV. Provider business mailing address

1051 BEACON ST STE 204
BROOKLINE MA
02446-5622
US

V. Phone/Fax

Practice location:
  • Phone: 617-589-1242
  • Fax:
Mailing address:
  • Phone: 617-589-1242
  • Fax: 617-485-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10003510
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: