Provider Demographics
NPI:1184981003
Name:DONAHUE, PAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:DONAHUE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 806
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-0806
Mailing Address - Country:US
Mailing Address - Phone:603-259-6888
Mailing Address - Fax:603-444-1333
Practice Address - Street 1:41 COTTAGE ST
Practice Address - Street 2:SUITE #1
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-5754
Practice Address - Country:US
Practice Address - Phone:603-259-6888
Practice Address - Fax:604-444-1333
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH213101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010201Medicaid