Provider Demographics
NPI:1093778862
Name:DONATO-POPKO, JOANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:DONATO-POPKO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:DONATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1251 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1434
Mailing Address - Country:US
Mailing Address - Phone:570-342-8434
Mailing Address - Fax:570-299-2521
Practice Address - Street 1:502 N BLAKELY ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1943
Practice Address - Country:US
Practice Address - Phone:570-342-8434
Practice Address - Fax:570-342-7446
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW007364L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA240818341001OtherMAGELLAN
PA4610464OtherAETNA
PAIP158388OtherGREEN SPRING
PAIP158388OtherGREEN SPRING