Provider Demographics
NPI:1679922546
Name:MELLS-MCCOY, DONNA LASHAWN
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LASHAWN
Last Name:MELLS-MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 BALCOM AVE
Mailing Address - Street 2:
Mailing Address - City:BLAKELY
Mailing Address - State:GA
Mailing Address - Zip Code:39823
Mailing Address - Country:US
Mailing Address - Phone:229-308-5798
Mailing Address - Fax:
Practice Address - Street 1:89 BALCOM AVE
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:GA
Practice Address - Zip Code:39823
Practice Address - Country:US
Practice Address - Phone:229-308-5798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker