Provider Demographics
NPI:1457904211
Name:DONNELLY, JOHNNA (LPC)
Entity Type:Individual
Prefix:
First Name:JOHNNA
Middle Name:
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-2646
Mailing Address - Country:US
Mailing Address - Phone:724-234-0379
Mailing Address - Fax:
Practice Address - Street 1:11676 PERRY HWY STE 2309
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7200
Practice Address - Country:US
Practice Address - Phone:814-201-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901774-TRNE101YA0400X
OHC.2002798101YA0400X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)