Provider Demographics
NPI:1912358094
Name:DONAGHUE, ELEANOR (PHD, LCPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:
Last Name:DONAGHUE
Suffix:
Gender:F
Credentials:PHD, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 ROCKVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1419
Mailing Address - Country:US
Mailing Address - Phone:703-927-0927
Mailing Address - Fax:
Practice Address - Street 1:1010 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1419
Practice Address - Country:US
Practice Address - Phone:703-927-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0687101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional