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Individual

TANISHA LAKIA NEWSOME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCAS A

Contact information

Practice address
2927 FORRESTAL DR, DURHAM, NC 27703-4785
(919) 519-0533
Mailing address
119 HERBERT ST, DURHAM, NC 27703-2205
(919) 519-0533

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-26837
NC
101YP1600X
Pastoral Counselor
Primary
TN6728981
NC
102X00000X
Poetry Therapist
NC
171M00000X
Case Manager/Care Coordinator
NC
174H00000X
Health Educator
NC

Other

Enumeration date
04/03/2019
Last updated
09/20/2025
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