Provider Demographics
NPI:1932402823
Name:KILMORE, DONNA L (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:L
Last Name:KILMORE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 W ROLLING CROSSROADS
Mailing Address - Street 2:209
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6208
Mailing Address - Country:US
Mailing Address - Phone:410-719-0086
Mailing Address - Fax:443-341-6218
Practice Address - Street 1:2 W ROLLING CROSSROADS
Practice Address - Street 2:209
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6208
Practice Address - Country:US
Practice Address - Phone:410-719-0086
Practice Address - Fax:443-341-6218
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2015-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD134111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1932402823Medicare PIN