1073866265 NPI number — MRS. JULIE ANN DONAHUE LPC, LPCMH

Table of content: MRS. JULIE ANN DONAHUE LPC, LPCMH (NPI 1073866265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073866265 NPI number — MRS. JULIE ANN DONAHUE LPC, LPCMH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONAHUE
Provider First Name:
JULIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, LPCMH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAKUNCHAK
Provider Other First Name:
JULIE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC, LPCMH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073866265
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 PINECREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19810-1414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-764-8652
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 PINECREST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-764-8652
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  PC005805 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: PC-0000548 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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