Provider Demographics
NPI:1154319788
Name:GIAQUINTO, DONNA MARIE (LPCC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:GIAQUINTO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CENTRAL PARK SQ
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-4001
Mailing Address - Country:US
Mailing Address - Phone:505-662-1419
Mailing Address - Fax:505-672-1739
Practice Address - Street 1:190 CENTRAL PARK SQ
Practice Address - Street 2:SUITE 105
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-4001
Practice Address - Country:US
Practice Address - Phone:505-662-1419
Practice Address - Fax:505-672-1739
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3837101YA0400X
NM0049101YM0800X
NM5251103T00000X
NM037148103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist