Provider Demographics
NPI:1861544512
Name:NEWTON, TRACY DIANNE (MED, LPC-S)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:DIANNE
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MED, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 REGENT'S PARK
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:214-274-9934
Mailing Address - Fax:972-542-5366
Practice Address - Street 1:201.5 E. VIRGINIA
Practice Address - Street 2:SUITE 4
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069
Practice Address - Country:US
Practice Address - Phone:214-274-9934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7110LCOtherBLUE CROSS BLUE SHIELD
TX548523OtherVALUE OPTIONS