Provider Demographics
NPI:1235719451
Name:DONOVAN INDIVIDUAL AND FAMILY COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:DONOVAN INDIVIDUAL AND FAMILY COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-961-5370
Mailing Address - Street 1:18888 US HIGHWAY 18 STE 106
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2315
Mailing Address - Country:US
Mailing Address - Phone:760-961-5370
Mailing Address - Fax:760-961-5354
Practice Address - Street 1:18888 US HIGHWAY 18 STE 205
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2315
Practice Address - Country:US
Practice Address - Phone:760-961-5370
Practice Address - Fax:760-961-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty