Provider Demographics
NPI:1902811334
Name:HARKINS, DONNA ELY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:ELY
Last Name:HARKINS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 CHARTER OAK AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5619
Mailing Address - Country:US
Mailing Address - Phone:410-803-0294
Mailing Address - Fax:410-803-0294
Practice Address - Street 1:141 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3576
Practice Address - Country:US
Practice Address - Phone:410-803-0294
Practice Address - Fax:410-803-0294
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03052103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD097421OtherMHN
MD110161OtherCOMPSYCH CORPORATION
MD45000506300OtherMD MEDICAL ASSISTANCE
MD022992 (MHS)OtherVALUE OPTIONS
MD345890OtherMAMSI, OPT CHOICE,ALLIANC
MD608252-01OtherBCBS RENDERING NUMBER
MDGP76DEOtherBLUE CROSS BLUE SHIELD
MD12779OtherDEPT OF REHAB SVCS-BEL AI
MD18524OtherJOHNS HOPKINS HEALTH CARE
MDM0480001OtherBLUE CHOICE FEDERAL
MDPVPB112169OtherAPS
MD5951011OtherAETNA
MD6148832OtherUNITED BEHAVIORAL HEALTH
MD608252-01OtherBCBS RENDERING NUMBER
MD45000506300OtherMD MEDICAL ASSISTANCE