Healthcare Provider Details

I. General information

NPI: 1073268785
Provider Name (Legal Business Name): DR. DONNA CLEMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONNA CLEMONS LPC

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 EXECUTIVE PARK DR STE 202
OPELIKA AL
36801-6199
US

IV. Provider business mailing address

3100 HAMILTON RD
OPELIKA AL
36804-7200
US

V. Phone/Fax

Practice location:
  • Phone: 618-444-3902
  • Fax:
Mailing address:
  • Phone: 618-444-3902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05802
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: