Provider Demographics
NPI:1376615328
Name:ALLRED, DONNA BURKE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:BURKE
Last Name:ALLRED
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 1:200 EAST BESSEMER AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-378-0597
Mailing Address - Fax:336-379-7466
Practice Address - Street 1:200 EAST BESSEMER AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-378-0597
Practice Address - Fax:336-379-7466
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNCC3323101Y00000X
NCNCLMFT404106H00000X
NCC0000891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical