Provider Demographics
NPI:1407008048
Name:WARNER, DONNA KAY (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:KAY
Last Name:WARNER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 E 50 N
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-8747
Mailing Address - Country:US
Mailing Address - Phone:765-447-0619
Mailing Address - Fax:
Practice Address - Street 1:100 EXECUTIVE DR
Practice Address - Street 2:SUITE G
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4884
Practice Address - Country:US
Practice Address - Phone:765-447-9545
Practice Address - Fax:765-447-9196
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004829A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN204406507OtherEINS