Provider Demographics
NPI:1215178579
Name:DONAHUE, MILDRED N (LCSW)
Entity Type:Individual
Prefix:
First Name:MILDRED
Middle Name:N
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 EASY ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04350-3503
Mailing Address - Country:US
Mailing Address - Phone:207-268-2002
Mailing Address - Fax:
Practice Address - Street 1:38 EASY ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:ME
Practice Address - Zip Code:04350-3503
Practice Address - Country:US
Practice Address - Phone:207-268-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC11131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical