Provider Demographics
NPI:1104491182
Name:NEWBORN, MELISSA JEAN (LPC, LCADC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:NEWBORN
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N HOCKEY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022-9502
Mailing Address - Country:US
Mailing Address - Phone:609-577-7616
Mailing Address - Fax:
Practice Address - Street 1:7 N HOCKEY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-9502
Practice Address - Country:US
Practice Address - Phone:609-577-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-23
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00215500101YA0400X
NJ37PC00352600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)