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General NPI Number Information
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NPI Number | 1952320566
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Entity Type | Individual
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Provider Name | TIMOTHY C DONOVAN MSW LCSW-R ACSW DCSW
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 75 CHESTNUT ST FIRST FLOOR, SUITE D
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City | ONEONTA
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State | NY
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Zip | 13820-2422
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Country | US
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Telephone | 607-432-1607
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Fax | 607-432-1607
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Provider Business Mailing Address
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Address Line | PO BOX 815
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City | ONEONTA
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State | NY
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Zip | 13820-0815
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Country | US
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Telephone | 607-432-1607
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Fax | 607-432-1607
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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 | PR032920
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004228A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I8680
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License Number State | OH
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