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NPI Code Detail

MEDICARE: BRENDA A DONALDSON LPC

MEDICARE: BRENDA A DONALDSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor983AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
162-31336OTHERALUBH PLUS
262-30336OTHERALUBH BASIC

General Provider Information

NPI Number : 1093931867
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA A DONALDSON LPC
Provider Business Mailing Address
First Line : 1402 E THREE NOTCH ST
Second Line :
City : ANDALUSIA
State : AL
Zip : 36420-3406
Country : US
Telephone Number : 334-222-6825
Fax Number :
Provider Business Practice Location Address
First Line : 19815 BAY BRANCH RD
Second Line :
City : ANDALUSIA
State : AL
Zip : 36420-9234
Country : US
Telephone Number : 334-222-2523
Fax Number : 334-222-4660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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Directions to “ BRENDA A DONALDSON LPC” Practice Location

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