Provider Demographics
NPI:1518414689
Name:JO-ANN L. DONATELLI, PH.D., INC.
Entity Type:Organization
Organization Name:JO-ANN L. DONATELLI, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JO-ANN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DONATELLI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-569-7640
Mailing Address - Street 1:1 RICHMOND SQUARE
Mailing Address - Street 2:SUITE 100C
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5154
Mailing Address - Country:US
Mailing Address - Phone:401-533-9994
Mailing Address - Fax:401-531-1532
Practice Address - Street 1:1 RICHMOND SQUARE
Practice Address - Street 2:SUITE 154E
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5100
Practice Address - Country:US
Practice Address - Phone:401-533-9994
Practice Address - Fax:401-531-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIJD69104Medicaid
RI007059932Medicare Oscar/Certification