Provider Demographics
NPI:1124635685
Name:DONOVAN, HEATHER PATRICIA (LMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:PATRICIA
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7304
Mailing Address - Country:US
Mailing Address - Phone:857-930-0217
Mailing Address - Fax:
Practice Address - Street 1:385 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7304
Practice Address - Country:US
Practice Address - Phone:857-930-0217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health