Provider Information for 1396094454
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
PHILLIS BEATRICE NEWTON LCSW
Sex: Female
NPI: 1396094454
Last Updated: 2018-08-27
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1396094454 | ||||||||||||
| Enumeration Date | 2012-09-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 385 CALLE DE ALEGRA STE A LAS CRUCES, NM 88005-3423 United States Phone: 575-526-1105 | Fax:575-524-4266 | ||||||||||||
| Primary Practice Address | 100 W GRIGGS AVE LAS CRUCES, NM 88001 United States Phone: 575-647-2800 | Fax:575-647-2898 | ||||||||||||
| Secondary Practice Address(es) | 2701 E YANDELL DR | ||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|