Provider Demographics
NPI:1588927289
Name:NEWMAN, TEDI DENEE (LPC)
Entity type:Individual
Prefix:
First Name:TEDI
Middle Name:DENEE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 OLD GRAY STATION RD APT 4
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3890
Mailing Address - Country:US
Mailing Address - Phone:919-744-4171
Mailing Address - Fax:
Practice Address - Street 1:109 BROYLES DR STE B
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2538
Practice Address - Country:US
Practice Address - Phone:919-744-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health