Provider Demographics
NPI:1710604962
Name:DONEGAN, CALI RENAE
Entity Type:Individual
Prefix:
First Name:CALI
Middle Name:RENAE
Last Name:DONEGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CALI
Other - Middle Name:RENAE
Other - Last Name:BICKNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 NE 67TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5734 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-3997
Practice Address - Country:US
Practice Address - Phone:816-400-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health