Provider Demographics
NPI:1922233295
Name:DONNELLY, JANINE L (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:L
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 8TH ST SE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2802
Mailing Address - Country:US
Mailing Address - Phone:240-343-4796
Mailing Address - Fax:
Practice Address - Street 1:731 8TH ST SE
Practice Address - Street 2:SUITE 301
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2802
Practice Address - Country:US
Practice Address - Phone:240-343-4796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500786251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical