Klynn David Donaldson, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-04812 Issued in NM

Practice address

3521 Del Rey Blvd
Las Cruces, NM 88012-7708

Phone

(505) 373-5057

Fax

(505) 373-5058

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467521815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6036",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880066036",
            "telephone_number": "505-373-5057",
            "fax_number": "505-373-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 DEL REY BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880127708",
            "telephone_number": "505-373-5057",
            "fax_number": "505-373-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "KLYNN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-04812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS NEW MEXICO",
            "identifier": "NM100802",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01187520",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dona Anna Chiropractic, Inc.
• Theresa Lynn Donahue, LMSW
• Mikayla Donart
• Brigit Dooley, MS, RDN, LD
• Rachel Doolittle-Loosemoore
• Araceli P Dorado
• Timothy Dorado

• Clinical Social Worker in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Clinical Social Worker in New Mexico

• 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.