Healthcare Provider Details

I. General information

NPI: 1104165901
Provider Name (Legal Business Name): BETH DONOVAN LCDP, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETH-ANN DONOVAN LCDP, LMHC

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 WILLIAMSON ST
FALL RIVER MA
02720-7010
US

IV. Provider business mailing address

44 WILLIAMSON ST
FALL RIVER MA
02720-7010
US

V. Phone/Fax

Practice location:
  • Phone: 508-493-5621
  • Fax:
Mailing address:
  • Phone: 401-424-1424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP00545
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00935
License Number StateRI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: