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General NPI Number Information
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NPI Number | 1174467849
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Entity Type | Organization
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Legal Business Name | ELIZABETH DONNELLY, LICENSED PROFESSIONAL CLINICAL COUNSELOR, P.C.
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 1148 N FORMOSA AVE APT 9
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-5856
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Country | US
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Telephone | 408-360-7199
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 NEHEMIAH DR
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City | MANTECA
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State | CA
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Zip | 95336-8529
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH DONNELLY
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Credential | LPCC
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Telephone | 408-360-7199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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