Provider Demographics
NPI:1649375916
Name:BOUNDY, DONNA J (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:J
Last Name:BOUNDY
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:WEST HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12491
Mailing Address - Country:US
Mailing Address - Phone:845-943-0883
Mailing Address - Fax:
Practice Address - Street 1:6 BIRCH ST
Practice Address - Street 2:
Practice Address - City:WEST HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12491
Practice Address - Country:US
Practice Address - Phone:845-943-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXR025894104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker