Provider Demographics
NPI:1689798670
Name:PALUMBO, DONNA MARIE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:PALUMBO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:PALUMBO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:83 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-1420
Mailing Address - Country:US
Mailing Address - Phone:401-231-0752
Mailing Address - Fax:
Practice Address - Street 1:83 BROWN AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-1420
Practice Address - Country:US
Practice Address - Phone:401-231-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW006561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical