Provider Demographics
NPI:1225689607
Name:SCALLAN, DONNA LEE (MA LPC , NCC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LEE
Last Name:SCALLAN
Suffix:
Gender:F
Credentials:MA LPC , NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TEAL CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-9169
Mailing Address - Country:US
Mailing Address - Phone:318-557-6442
Mailing Address - Fax:
Practice Address - Street 1:600 TEAL CIR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-9169
Practice Address - Country:US
Practice Address - Phone:318-557-6442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7257101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional