Provider Demographics
NPI:1225176308
Name:AMUNDSON, DONNA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:AMUNDSON
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 1:225 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-2018
Mailing Address - Country:US
Mailing Address - Phone:732-469-3370
Mailing Address - Fax:
Practice Address - Street 1:225 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-2018
Practice Address - Country:US
Practice Address - Phone:732-469-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013748001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical