Provider Demographics
NPI:1144649849
Name:DONAHUE, MARY BELL (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:BELL
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4931 N.W. 58TH TERR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067
Mailing Address - Country:US
Mailing Address - Phone:954-803-6295
Mailing Address - Fax:
Practice Address - Street 1:901 S 62ND AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-1848
Practice Address - Country:US
Practice Address - Phone:954-893-0109
Practice Address - Fax:854-893-9750
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW70941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical