Provider Demographics
NPI:1972909935
Name:NEWBY, MANDI LYN (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:MANDI
Middle Name:LYN
Last Name:NEWBY
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 METHEGLIN DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-7292
Mailing Address - Country:US
Mailing Address - Phone:254-760-7424
Mailing Address - Fax:
Practice Address - Street 1:1111 N GENERAL BRUCE DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-2468
Practice Address - Country:US
Practice Address - Phone:254-760-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional