Provider Demographics
NPI:1780759639
Name:TREAT, DONALD RAY (LCSW)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:RAY
Last Name:TREAT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3503 E DOGWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-9309
Mailing Address - Country:US
Mailing Address - Phone:502-243-2346
Mailing Address - Fax:
Practice Address - Street 1:2676 CHARLESTOWN RD
Practice Address - Street 2:STE 9
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2574
Practice Address - Country:US
Practice Address - Phone:812-948-8522
Practice Address - Fax:812-948-8613
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003931A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical