Provider Demographics
NPI:1104294149
Name:NEWTON, MARY A (LMSW, PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9117 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9438
Mailing Address - Country:US
Mailing Address - Phone:734-846-3172
Mailing Address - Fax:734-677-3151
Practice Address - Street 1:2500 PACKARD ST
Practice Address - Street 2:104A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6827
Practice Address - Country:US
Practice Address - Phone:734-846-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801079674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health