Provider Demographics
NPI:1619031325
Name:AZIA-DONAHUE, REBECCA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:AZIA-DONAHUE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PAMELA LN
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-8810
Mailing Address - Country:US
Mailing Address - Phone:857-259-2173
Mailing Address - Fax:
Practice Address - Street 1:7 LINCOLN ST STE 304B
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3021
Practice Address - Country:US
Practice Address - Phone:857-259-2173
Practice Address - Fax:781-587-1711
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6526101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)