MEDICARE: NEWTON PSYCHOTHERAPY AND CONSULTING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	7436	NC

General Provider Information

NPI Number	:	1174800312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWTON PSYCHOTHERAPY AND CONSULTING, PLLC

Provider Business Mailing Address
First Line	:	7406 CHAPEL HILL RD
Second Line	:	SUITE B
City	:	RALEIGH
State	:	NC
Zip	:	27607-5077
Country	:	US
Telephone Number	:	919-526-0256
Fax Number	:

Provider Business Practice Location Address
First Line	:	7406 CHAPEL HILL RD
Second Line	:	SUITE B
City	:	RALEIGH
State	:	NC
Zip	:	27607-5077
Country	:	US
Telephone Number	:	919-526-0256
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST / OWNER
Name	:	MR. BERNARD JAMES NEWTON JR.
Credential	:	LPC
Telephone Number	:	919-526-0256

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	11/15/2011

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