Provider Demographics
NPI:1508134875
Name:DONELAN, JILL M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:DONELAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:M
Other - Last Name:DONELAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:150 LOWER WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2890
Mailing Address - Country:US
Mailing Address - Phone:413-322-4984
Mailing Address - Fax:133-224-4992
Practice Address - Street 1:331 WETHERSFIELD AVE
Practice Address - Street 2:THE VILLAGE FOR FAMILIES AND CHILDREN
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114
Practice Address - Country:US
Practice Address - Phone:860-236-4511
Practice Address - Fax:860-231-8449
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10049-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical