Provider Demographics
NPI:1780607143
Name:LITINSKY, DONNA LESLIE
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LESLIE
Last Name:LITINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25600 WOODWARD AVE
Mailing Address - Street 2:STE 215
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0945
Mailing Address - Country:US
Mailing Address - Phone:810-744-3600
Mailing Address - Fax:810-744-2597
Practice Address - Street 1:25600 WOODWARD AVE
Practice Address - Street 2:STE 215
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0945
Practice Address - Country:US
Practice Address - Phone:248-399-7447
Practice Address - Fax:248-429-1550
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010821761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical