Provider Demographics
NPI:1568564185
Name:MACIOROWSKI, DONNA J (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:J
Last Name:MACIOROWSKI
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1759 TERRAPIN NECK RD
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-4159
Mailing Address - Country:US
Mailing Address - Phone:304-876-1514
Mailing Address - Fax:
Practice Address - Street 1:2000 FOUNDATION WAY
Practice Address - Street 2:SUITE 3500
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-9003
Practice Address - Country:US
Practice Address - Phone:304-264-1442
Practice Address - Fax:304-264-4317
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1795101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV90488OtherNCC CERTIFICATION NUMBER
WV1795OtherLPC LICENSE NUMBER