1134448822 NPI number — MS. DEVON MARTINDALE DONOHUE MA, LCMHC, ATR

Table of content: MS. DEVON MARTINDALE DONOHUE MA, LCMHC, ATR (NPI 1134448822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134448822 NPI number — MS. DEVON MARTINDALE DONOHUE MA, LCMHC, ATR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONOHUE
Provider First Name:
DEVON
Provider Middle Name:
MARTINDALE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LCMHC, ATR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134448822
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 PORTSMOUTH AVE STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STRATHAM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03885-6528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-902-9012
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1245 WASHINGTON RD FL 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RYE
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03870-2339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-986-9499
Provider Business Practice Location Address Fax Number:
845-986-9049
Provider Enumeration Date:
05/20/2010

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: 101YM0800X , with the licence number:  2122 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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