Provider Demographics
NPI:1902949688
Name:NEWSON, MACHANTA EVETTE (MSSW)
Entity Type:Individual
Prefix:MRS
First Name:MACHANTA
Middle Name:EVETTE
Last Name:NEWSON
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 JACOB CT
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3869
Mailing Address - Country:US
Mailing Address - Phone:901-550-0406
Mailing Address - Fax:
Practice Address - Street 1:700 W MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-1629
Practice Address - Country:US
Practice Address - Phone:469-808-9730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 1041C0700X
TX627001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker