Provider Demographics
NPI:1750427894
Name:DONATO, DONNA MARIA (LPC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIA
Last Name:DONATO
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 1:4064 PHILWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-3910
Mailing Address - Country:US
Mailing Address - Phone:901-324-1491
Mailing Address - Fax:
Practice Address - Street 1:5118 PARK AVE
Practice Address - Street 2:STE. 525
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-5720
Practice Address - Country:US
Practice Address - Phone:901-682-3371
Practice Address - Fax:901-682-9728
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional