Provider Demographics
NPI:1013344860
Name:DONOHUE, LISA (LPC, LADC, LCAT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:LPC, LADC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 BAINBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2314
Mailing Address - Country:US
Mailing Address - Phone:203-505-3063
Mailing Address - Fax:
Practice Address - Street 1:268 POST RD STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6220
Practice Address - Country:US
Practice Address - Phone:203-505-3063
Practice Address - Fax:855-764-8365
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-10
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT44.001060101YA0400X
CT1069101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)