Provider Demographics
NPI:1346514213
Name:COUNSELING BY KATHLEEN DONSON,LLC
Entity Type:Organization
Organization Name:COUNSELING BY KATHLEEN DONSON,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DONSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-687-6830
Mailing Address - Street 1:1869 ROUTE 739 STE 1
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-3409
Mailing Address - Country:US
Mailing Address - Phone:570-687-6830
Mailing Address - Fax:570-828-2798
Practice Address - Street 1:1869 SUITE 1 ROUTE 739
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-3409
Practice Address - Country:US
Practice Address - Phone:570-687-6830
Practice Address - Fax:570-828-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO16056251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102700978Medicaid