Healthcare Provider Details

I. General information

NPI: 1114842267
Provider Name (Legal Business Name): TESSA NEWTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6310 GENOA AVE STE D
LUBBOCK TX
79424-2708
US

IV. Provider business mailing address

521 N BRENTWOOD AVE APT B
LUBBOCK TX
79416-1371
US

V. Phone/Fax

Practice location:
  • Phone: 806-855-3050
  • Fax:
Mailing address:
  • Phone: 817-675-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103362
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: