Provider Demographics
NPI:1629619135
Name:CHESHIRE, DONNA LYNN (LCSW-A)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:CHESHIRE
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 TAYLOR SPENCE RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-7911
Mailing Address - Country:US
Mailing Address - Phone:252-468-2217
Mailing Address - Fax:
Practice Address - Street 1:2269 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2841
Practice Address - Country:US
Practice Address - Phone:252-439-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0129241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical