Provider Demographics
NPI:1598437733
Name:VEADER, DONNA DANIELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:DANIELLE
Last Name:VEADER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 TANGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2729
Mailing Address - Country:US
Mailing Address - Phone:678-612-7456
Mailing Address - Fax:
Practice Address - Street 1:2609 TANGLEWOOD RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2729
Practice Address - Country:US
Practice Address - Phone:678-612-7456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0043921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW004392OtherGA LICENSE NUMBER