Provider Demographics
NPI:1598980591
Name:DONALD, BROOKE ASHLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ASHLEY
Last Name:DONALD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 HILL RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1059
Mailing Address - Country:US
Mailing Address - Phone:973-335-5525
Mailing Address - Fax:
Practice Address - Street 1:95 MOUNT KEMBLE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5155
Practice Address - Country:US
Practice Address - Phone:973-971-4741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100495800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ861106332OtherEIN FOR PRIVATE PRACTICE