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NPI Code Detail

MEDICARE: GWENDOLYN JOANN NEWBY LPC

MEDICARE: GWENDOLYN JOANN NEWBY LPC
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
1101Y00000XCounselorLPC014806GA

General Provider Information

NPI Number : 1215774450
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWENDOLYN JOANN NEWBY LPC
Provider Business Mailing Address
First Line : 4996 DAYBREAK LN
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-1708
Country : US
Telephone Number : 706-580-5988
Fax Number :
Provider Business Practice Location Address
First Line : 2022 15TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-1699
Country : US
Telephone Number : 706-649-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2024
Last Update Date : 07/17/2024

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Directions to “ GWENDOLYN JOANN NEWBY LPC” Practice Location

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