Provider Demographics
NPI:1477865186
Name:HENRY, DONNA (LPC, CDCI)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:LPC, CDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W 41ST AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-6604
Mailing Address - Country:US
Mailing Address - Phone:907-782-4553
Mailing Address - Fax:
Practice Address - Street 1:701 W 41ST AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6604
Practice Address - Country:US
Practice Address - Phone:907-782-4553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK633101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor