Provider Demographics
NPI:1740940378
Name:DONOHOE, ELAINA E (LPC, CRC)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:E
Last Name:DONOHOE
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 E PARKCENTER BLVD # 222
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-6721
Mailing Address - Country:US
Mailing Address - Phone:208-309-2642
Mailing Address - Fax:
Practice Address - Street 1:832 E RIVERPARK LN
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4099
Practice Address - Country:US
Practice Address - Phone:208-309-2642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID7850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty