Provider Demographics
NPI:1598428567
Name:DONOHOE, CASEY (LSW)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:DONOHOE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 MONTEZUMA RD
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:CO
Mailing Address - Zip Code:80435-7621
Mailing Address - Country:US
Mailing Address - Phone:410-952-5139
Mailing Address - Fax:
Practice Address - Street 1:101 W MAIN ST STE O
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5513
Practice Address - Country:US
Practice Address - Phone:970-200-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099232151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical