Provider Demographics
NPI:1447204359
Name:TOWNSEND, DONALD R (PHD, LP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29446 N 51ST PL
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-2319
Mailing Address - Country:US
Mailing Address - Phone:507-398-5518
Mailing Address - Fax:
Practice Address - Street 1:3040 E CACTUS RD
Practice Address - Street 2:STE A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7196
Practice Address - Country:US
Practice Address - Phone:507-398-5518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4344103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN257235400Medicaid
MN257235400Medicaid