Individual provider Active NPI

Lisaanne Marie Donahue, LPC

  • Counselor
  • Glassboro, NJ
National Provider Identifier
1194876615
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
37PC00062500 Issued in NJ
Practice address
42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone
(856) 863-0006
Fax
(856) 881-7614
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 37PC00062500 NJ Primary

Addresses

Primary practice location

42 Delsea Dr S
Glassboro, NJ 08028-2621

Mailing address

42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone (856) 863-0006

Other identifiers 1

IdentifierTypeStateIssuer
284013000OtherNJMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37PC00062500NJMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194876615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DELSEA DR S",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282621",
            "telephone_number": "856-863-0006",
            "fax_number": "856-881-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 DELSEA DR S",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282621",
            "telephone_number": "856-863-0006",
            "fax_number": "856-881-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "LISAANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37PC00062500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "284013000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.