Provider Demographics
NPI:1538287271
Name:ADKERSON, DONYA (LCPC, LSOTP, LSOE)
Entity Type:Individual
Prefix:
First Name:DONYA
Middle Name:
Last Name:ADKERSON
Suffix:
Gender:F
Credentials:LCPC, LSOTP, LSOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-0639
Mailing Address - Country:US
Mailing Address - Phone:618-288-8085
Mailing Address - Fax:618-288-8959
Practice Address - Street 1:88 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-1415
Practice Address - Country:US
Practice Address - Phone:618-288-8085
Practice Address - Fax:618-288-8959
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-000271174400000X
180000271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180000271OtherIDFPR