Healthcare Provider Details

I. General information

NPI: 1275250425
Provider Name (Legal Business Name): SHANNON DANIELLE DONLEY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 GRAPHICS WAY STE 3100
LEWIS CENTER OH
43035-0238
US

IV. Provider business mailing address

7100 GRAPHICS WAY STE 3100
LEWIS CENTER OH
43035-0238
US

V. Phone/Fax

Practice location:
  • Phone: 740-428-0428
  • Fax: 740-909-4077
Mailing address:
  • Phone: 740-428-0428
  • Fax: 740-909-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS.2208468
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: