Provider Demographics
NPI:1962427617
Name:NEWELL-LOYKO, CHRISTINE (MSW, CADC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:NEWELL-LOYKO
Suffix:
Gender:F
Credentials:MSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-1338
Mailing Address - Country:US
Mailing Address - Phone:508-865-4902
Mailing Address - Fax:
Practice Address - Street 1:255 PARK AVE STE 900
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1978
Practice Address - Country:US
Practice Address - Phone:508-753-7902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2018-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0312AD101YA0400X
MA1020201104100000X, 1041C0700X
RIISW020101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP05915Medicaid
MA102020OtherTUFTS