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General NPI Number Information
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NPI Number | 1114469426
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Entity Type | Individual
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Provider Name | GWEN BILLUPS-NEWTON LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/17/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 15 OLD FALLS ROAD BENJAMIN COSON ELEMENTARY
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City | FALLSBURG
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State | NY
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Zip | 12733
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Country | US
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Telephone | 845-434-4110
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Fax | 845-434-0871
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Provider Business Mailing Address
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Address Line | PO BOX 123 FALLSBURG CENTRAL SCH. DIST.
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City | FALLSBURG
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State | NY
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Zip | 12733
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Country | US
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Telephone | 845-434-6800
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Fax | 845-434-0871
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 73078146
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License Number State | NY
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