Provider Demographics
NPI:1114689593
Name:DONNELLY, ERIN ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 COURTNEY LAKES CIR APT 106
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2392
Mailing Address - Country:US
Mailing Address - Phone:561-425-0700
Mailing Address - Fax:
Practice Address - Street 1:265 COURTNEY LAKES CIR APT 106
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2392
Practice Address - Country:US
Practice Address - Phone:561-425-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH169691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health