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General NPI Number Information
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NPI Number | 1073882338
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Entity Type | Organization
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Legal Business Name | NEWSOM PSYCHOLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 2646 S LOOP W STE 422
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City | HOUSTON
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State | TX
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Zip | 77054-2678
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Country | US
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Telephone | 713-640-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 2646 S LOOP W STE 422
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City | HOUSTON
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State | TX
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Zip | 77054-2678
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | WALTER NEWSOM
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Credential |
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Telephone | 713-640-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 31249
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License Number State | TX
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