Provider Demographics
NPI:1891050852
Name:MCSPADDEN, DONNA SUE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:SUE
Last Name:MCSPADDEN
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 1:4 SHACKLEFORD PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1826
Mailing Address - Country:US
Mailing Address - Phone:501-680-6079
Mailing Address - Fax:
Practice Address - Street 1:4 SHACKLEFORD PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1826
Practice Address - Country:US
Practice Address - Phone:501-680-6079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4931-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical