=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972478626
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROXXANNE A NEWMAN LCDP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2025
-----------------------------------------------------
Last Update Date | 11/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 WALKER AVE
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865-2136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-403-4804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 WALKER AVE
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865-2136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-403-4804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | CDP01064
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------