Provider Demographics
NPI:1154601268
Name:NEWTON, TARA D (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:D
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12274 PENDER CREEK CIR
Mailing Address - Street 2:UNIT B
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3937
Mailing Address - Country:US
Mailing Address - Phone:703-593-7185
Mailing Address - Fax:
Practice Address - Street 1:12274 PENDER CREEK CIR
Practice Address - Street 2:UNIT B
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3937
Practice Address - Country:US
Practice Address - Phone:703-593-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040073751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical