=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154289411
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL DONAHUE LMSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2026
-----------------------------------------------------
Last Update Date | 01/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2042 S GARRISON AVE
-----------------------------------------------------
City | CARTHAGE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64836-3612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-627-9994
-----------------------------------------------------
Fax | 417-627-9995
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 705 W 26TH ST
-----------------------------------------------------
City | JOPLIN
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64804-1904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-627-9994
-----------------------------------------------------
Fax | 417-627-9995
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 2023038356
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------