Individual ProviderTom John NewellCounselorBehavioral Health & Social Service ProvidersPractice Address1250 Coddingtown Ctr, Santa Rosa, CA 95401-3515(707) 565-7648PECOS EnrollmentBased on the most recent information from CMS, provider Tom John Newell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1942356001Provider TypeIndividualFull NameNewell, Tom JohnGenderMaleSole ProprietorNoEnumeration Date1/25/2007Last Updated8/11/2014Contact InformationPractice LocationPractice Address1250 Coddingtown Ctr, Santa Rosa, CA 95401-3515Phone(707) 565-7648FaxUnlisted FaxMailing LocationMailing Address1250 Coddingtown Ctr, Santa Rosa, CA 95401-3515PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseMFT24309CaliforniaCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense24309California