Provider Demographics
NPI:1609141688
Name:NEWKIRK, SCOTT (PSYD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:NEWKIRK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LAUREL AVE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1469
Mailing Address - Country:US
Mailing Address - Phone:845-458-4558
Mailing Address - Fax:845-458-4559
Practice Address - Street 1:21 LAUREL AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1469
Practice Address - Country:US
Practice Address - Phone:845-458-4558
Practice Address - Fax:845-458-4559
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016021103TA0700X, 103TC0700X, 103TC2200X, 103TF0000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy