Provider Demographics
NPI:1790089548
Name:DONALDSON, KRISTINE R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:R
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 N WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:FARMER CITY
Mailing Address - State:IL
Mailing Address - Zip Code:61842-1123
Mailing Address - Country:US
Mailing Address - Phone:217-200-0864
Mailing Address - Fax:
Practice Address - Street 1:519 N WILLIAM ST
Practice Address - Street 2:
Practice Address - City:FARMER CITY
Practice Address - State:IL
Practice Address - Zip Code:61842-1123
Practice Address - Country:US
Practice Address - Phone:217-200-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical