Provider Demographics
NPI:1841786076
Name:DONATO, KAITLYND EMILY (BSW, LSW, LCDC III)
Entity Type:Individual
Prefix:
First Name:KAITLYND
Middle Name:EMILY
Last Name:DONATO
Suffix:
Gender:F
Credentials:BSW, LSW, LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 WOODLAND AVE STE 703
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-2775
Mailing Address - Country:US
Mailing Address - Phone:216-431-2018
Mailing Address - Fax:
Practice Address - Street 1:6001 WOODLAND AVE STE 703
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-2775
Practice Address - Country:US
Practice Address - Phone:216-431-2018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.162256101YA0400X, 172V00000X
OHS.2308919104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0300935Medicaid