Provider Demographics
NPI:1225315054
Name:DONATELLI, LAURA HOPE (LISW-CP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HOPE
Last Name:DONATELLI
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 VARDEN DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5285
Mailing Address - Country:US
Mailing Address - Phone:803-642-3801
Mailing Address - Fax:803-642-5538
Practice Address - Street 1:310 BARNWELL AVE NE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-4406
Practice Address - Country:US
Practice Address - Phone:803-641-4144
Practice Address - Fax:803-641-4177
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical