Healthcare Provider Details

I. General information

NPI: 1225940299
Provider Name (Legal Business Name): MATTHEW NEWMAN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7027 MONTGOMERY BLVD NE STE F
ALBUQUERQUE NM
87109-1529
US

IV. Provider business mailing address

10631 SHOOTING STAR ST NW
ALBUQUERQUE NM
87114-3972
US

V. Phone/Fax

Practice location:
  • Phone: 505-880-0100
  • Fax: 505-880-0102
Mailing address:
  • Phone: 505-934-3480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2023-0715
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: