Provider Demographics
NPI:1225211535
Name:DONATELLI, DONNA LYNNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LYNNE
Last Name:DONATELLI
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 1:5 FOXCROFT ROAD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3720
Mailing Address - Country:US
Mailing Address - Phone:516-365-8499
Mailing Address - Fax:
Practice Address - Street 1:5 FOXCROFT ROAD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3720
Practice Address - Country:US
Practice Address - Phone:516-365-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04807311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP5701OtherMEDICARE PROVIDER #