Basic Information
| Provider Information | |||||||||
| NPI: | 1114282282 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEWTON | ||||||||
| FirstName: | ROBERT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1149 | ||||||||
| Address2: | |||||||||
| City: | NEBO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287610964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286593418 | ||||||||
| FaxNumber: | 8286593291 | ||||||||
| Practice Location | |||||||||
| Address1: | 1251 PINNACLE CHURCH ROAD | ||||||||
| Address2: | |||||||||
| City: | NEBO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287610964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286593418 | ||||||||
| FaxNumber: | 8286593291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2012 | ||||||||
| LastUpdateDate: | 07/05/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 2481 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.