Provider Demographics
NPI:1003152372
Name:SUDEN, DONNA JEAN (LCPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:SUDEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:MT
Mailing Address - Zip Code:59230-1697
Mailing Address - Country:US
Mailing Address - Phone:406-228-9349
Mailing Address - Fax:
Practice Address - Street 1:1009 6TH AVE N
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MT
Practice Address - Zip Code:59230-1697
Practice Address - Country:US
Practice Address - Phone:406-228-9349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health