Provider Demographics
NPI:1720396336
Name:WELCH, DONNA LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:WELCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:LEE
Other - Last Name:MCKENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:166 OLD WATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-5373
Mailing Address - Country:US
Mailing Address - Phone:207-465-9001
Mailing Address - Fax:
Practice Address - Street 1:166 OLD WATERVILLE RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5373
Practice Address - Country:US
Practice Address - Phone:207-465-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC12175101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health