=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912295965
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATE DONNALLY LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2011
-----------------------------------------------------
Last Update Date | 01/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 PARK ST
-----------------------------------------------------
City | MORRISVILLE
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05661-9098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-730-9086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 394
-----------------------------------------------------
City | HYDE PARK
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05655-0394
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-730-9086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 089-0076013
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------