Provider Demographics
NPI:1841354396
Name:DONALDSON, AMBER LEIGH (MA, LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 LIBERTY ST NE
Mailing Address - Street 2:SUITE 202D
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3682
Mailing Address - Country:US
Mailing Address - Phone:541-619-0348
Mailing Address - Fax:
Practice Address - Street 1:189 LIBERTY ST NE
Practice Address - Street 2:SUITE 202 D
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3682
Practice Address - Country:US
Practice Address - Phone:541-619-0348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional