Provider Demographics
NPI:1942364468
Name:DONNELLY, LINDA G (MSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:G
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:DONNELLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1109 CHURCH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1104
Mailing Address - Country:US
Mailing Address - Phone:503-949-6266
Mailing Address - Fax:
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-585-5351
Practice Address - Fax:503-585-4908
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical