Provider Demographics
NPI:1265635601
Name:HUBER, DONNA SUE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:SUE
Last Name:HUBER
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 1:4712 CAROLINA SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-8322
Mailing Address - Country:US
Mailing Address - Phone:502-261-9948
Mailing Address - Fax:
Practice Address - Street 1:3900 KRESGE WAY
Practice Address - Street 2:SUITE 30
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4660
Practice Address - Country:US
Practice Address - Phone:502-550-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical