Provider Demographics
NPI:1215457569
Name:NEWTON, SHAKELL MONIQUE (PASTORAL)
Entity type:Individual
Prefix:
First Name:SHAKELL
Middle Name:MONIQUE
Last Name:NEWTON
Suffix:
Gender:
Credentials:PASTORAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SOUTH CONGRESS AVENUE
Mailing Address - Street 2:Q3
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1155
Mailing Address - Country:US
Mailing Address - Phone:718-753-3081
Mailing Address - Fax:
Practice Address - Street 1:4801 SOUTH CONGRESS AVENUE
Practice Address - Street 2:Q3
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:718-954-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver