Provider Demographics
NPI:1912055393
Name:AKEY, DONALD LEROY (LCSW LADAC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LEROY
Last Name:AKEY
Suffix:
Gender:M
Credentials:LCSW LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5517 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120
Mailing Address - Country:US
Mailing Address - Phone:901-497-3182
Mailing Address - Fax:
Practice Address - Street 1:2670 UNION EXTENDED SUITE #610
Practice Address - Street 2:CONCERN EAP
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112
Practice Address - Country:US
Practice Address - Phone:901-458-4000
Practice Address - Fax:901-458-0048
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000004157104100000X
MSC5951104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNLSW0000004157OtherLCSW
MSC5951OtherLCSW
TNLSW0000004157OtherLCSW