Provider Demographics
NPI:1760045215
Name:DONNELLY, ARLENE MARIE (LPC, CAADC, CCTP,)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARIE
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:LPC, CAADC, CCTP,
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:MARIE
Other - Last Name:INNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:88 NETTLES ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49037-7863
Mailing Address - Country:US
Mailing Address - Phone:517-817-8195
Mailing Address - Fax:
Practice Address - Street 1:115 MICHIGAN AVE W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3605
Practice Address - Country:US
Practice Address - Phone:269-967-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017009103TC1900X
MI6401019149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling