Provider Demographics
NPI:1760815021
Name:DEWAN, DONNA (LPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:DEWAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 MACEDONIA RD
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:NC
Mailing Address - Zip Code:28773-7766
Mailing Address - Country:US
Mailing Address - Phone:607-353-2391
Mailing Address - Fax:828-749-2263
Practice Address - Street 1:1398 MACEDONIA RD
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:NC
Practice Address - Zip Code:28773-7766
Practice Address - Country:US
Practice Address - Phone:607-353-2391
Practice Address - Fax:828-749-2263
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional