Provider Demographics
NPI:1467660340
Name:DEASCENTIS, DONNA M (MSE, LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:DEASCENTIS
Suffix:
Gender:F
Credentials:MSE, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 BELLEVUE AVE
Mailing Address - Street 2:SUITE 306B
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840
Mailing Address - Country:US
Mailing Address - Phone:401-450-2704
Mailing Address - Fax:401-846-1811
Practice Address - Street 1:174 BELLEVUE AVE
Practice Address - Street 2:SUITE 306B
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3582
Practice Address - Country:US
Practice Address - Phone:401-450-2704
Practice Address - Fax:401-846-1811
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00482101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health