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DR. JACK D NEWSOME PH.D LCPC NPI 1124169354


NPI Information

NPI: 1124169354
Provider Name: DR. JACK D NEWSOME, PH.D LCPC
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
732 WASHINGTON AVE
POCATELLO, ID
ZIP 83201
Phone: (208) 478-9822
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DR. Jack D Newsome, PH.D LCPC is a counselor in Pocatello, ID. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. DR. Jack D Newsome, PH.D LCPC NPI is 1124169354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

732 WASHINGTON AVE
POCATELLO, ID
ZIP 83201-748
Phone: (208) 478-9822
Fax: (208) 478-6790

The enumeration date for this NPI number is 2/9/2007 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorLCPC 3403IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000010151135MEDICARE UPINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.