Provider Demographics
NPI:1972011062
Name:NEWTON, EBONE SHANIA (EDS, LPC)
Entity type:Individual
Prefix:
First Name:EBONE
Middle Name:SHANIA
Last Name:NEWTON
Suffix:
Gender:F
Credentials:EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 SOUTHVIEW LN STE 103 PMB 178
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-6391
Mailing Address - Country:US
Mailing Address - Phone:205-565-8884
Mailing Address - Fax:
Practice Address - Street 1:1105 SOUTHVIEW LN STE 103 PMB 178
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-6391
Practice Address - Country:US
Practice Address - Phone:205-565-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC04825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional