Provider Demographics
NPI:1982715660
Name:DONELAN, JILL A (NCC, LPC-MH, QMHP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:A
Last Name:DONELAN
Suffix:
Gender:F
Credentials:NCC, LPC-MH, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-6735
Mailing Address - Country:US
Mailing Address - Phone:605-480-3683
Mailing Address - Fax:
Practice Address - Street 1:1711 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-6735
Practice Address - Country:US
Practice Address - Phone:605-480-3683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2241101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health