Provider Demographics
NPI:1285419275
Name:MCNEW, JAY RYAN
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:RYAN
Last Name:MCNEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 FAY CIR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-5531
Mailing Address - Country:US
Mailing Address - Phone:423-457-8777
Mailing Address - Fax:
Practice Address - Street 1:89 FAY CIR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5531
Practice Address - Country:US
Practice Address - Phone:423-457-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician