Provider Demographics
NPI:1508968165
Name:ROSENTHAL, DONNA SUE (LCMHC)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:SUE
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 REVERE RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1642
Mailing Address - Country:US
Mailing Address - Phone:516-625-0916
Mailing Address - Fax:
Practice Address - Street 1:240 REVERE RD
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1642
Practice Address - Country:US
Practice Address - Phone:516-625-0916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0003129101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health