Provider Demographics
NPI:1255678835
Name:DONLON, SUE A (LISW-S)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:A
Last Name:DONLON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-0085
Mailing Address - Country:US
Mailing Address - Phone:614-813-6833
Mailing Address - Fax:
Practice Address - Street 1:870 HIGH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4139
Practice Address - Country:US
Practice Address - Phone:614-813-6833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 0700431 SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker