Healthcare Provider Details

I. General information

NPI: 1215845136
Provider Name (Legal Business Name): DOLORES DONOVAN LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ZACHARY RD
MANCHESTER NH
03109-5607
US

IV. Provider business mailing address

200 ZACHARY RD
MANCHESTER NH
03109-5607
US

V. Phone/Fax

Practice location:
  • Phone: 603-494-3132
  • Fax:
Mailing address:
  • Phone: 603-494-3132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number532
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: