Individual provider · Type 1 NPI

Jack D. Newsome, PH.D LCPC

Counselor · Pocatello, ID

NPI number 1124169354 Active

Practice location

732 Washington Ave
Pocatello, ID 83201-3748

Call (208) 478-9822 Map

Fax (208) 478-6790

Mailing address

944 Dixon
Idaho Falls, ID 83401

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XLCPC 3403 (ID)

Counselor: 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.

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About NPI 1124169354

Jack D. Newsome, PH.D LCPC's National Provider Identifier is 1124169354, issued on Feb 9, 2007. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Pocatello, ID. The record was last updated on Jul 9, 2007.