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General NPI Number Information
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NPI Number | 1598428567
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Entity Type | Individual
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Provider Name | CASEY DONOHOE LSW
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Gender | Female
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 101 W MAIN ST STE O
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City | FRISCO
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State | CO
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Zip | 80443-5513
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Country | US
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Telephone | 970-200-8563
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Fax |
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Provider Business Mailing Address
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Address Line | 5402 MONTEZUMA RD
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City | MONTEZUMA
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State | CO
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Zip | 80435-7621
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Country | US
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Telephone | 410-952-5139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW.0009923215
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License Number State | CO
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