Healthcare Provider Details

I. General information

NPI: 1518996164
Provider Name (Legal Business Name): NEAL NEWMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S CASSADY AVE
COLUMBUS OH
43209-1714
US

IV. Provider business mailing address

150 S CASSADY AVE
COLUMBUS OH
43209-1714
US

V. Phone/Fax

Practice location:
  • Phone: 614-239-1083
  • Fax: 614-688-3440
Mailing address:
  • Phone: 614-239-1083
  • Fax: 614-688-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2020
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number2020
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2020
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: