Provider Demographics
NPI:1619232048
Name:DONNELLY, CLAIRE FRANCES (ATR, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:CLAIRE
Middle Name:FRANCES
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:ATR, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HOLTON ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3555
Mailing Address - Country:US
Mailing Address - Phone:781-307-2219
Mailing Address - Fax:
Practice Address - Street 1:32 HOLTON ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3555
Practice Address - Country:US
Practice Address - Phone:781-307-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8735101YM0800X
MA12-058221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist