Provider Demographics
NPI:1306655428
Name:NEWSOM, SCHELLEY MURDOCK (LMSW)
Entity type:Individual
Prefix:
First Name:SCHELLEY
Middle Name:MURDOCK
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SCHELLEY
Other - Middle Name:MURDOCK
Other - Last Name:CROCKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1201 E. 9TH ST
Mailing Address - Street 2:ATTN: CLC SW
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418
Mailing Address - Country:US
Mailing Address - Phone:903-583-6533
Mailing Address - Fax:
Practice Address - Street 1:1201 E. 9TH ST
Practice Address - Street 2:ATTN: CLC SW
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418
Practice Address - Country:US
Practice Address - Phone:903-583-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50340104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker