Provider Demographics
NPI:1508993247
Name:DONARSKI, JANENE MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:JANENE
Middle Name:MARIE
Last Name:DONARSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4384 LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9311
Mailing Address - Country:US
Mailing Address - Phone:269-982-3832
Mailing Address - Fax:269-281-0351
Practice Address - Street 1:2460 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1874
Practice Address - Country:US
Practice Address - Phone:269-982-3832
Practice Address - Fax:269-281-0351
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010878451041C0700X
MI6301013851103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI62-79049Medicaid
MI0P21820001Medicare PIN