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NPI Code Detail

MEDICARE: KATE DONNALLY LCSW

MEDICARE: KATE DONNALLY LCSW
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
11041C0700XClinical Social Worker089-0076013VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912295965
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATE DONNALLY LCSW
Provider Business Mailing Address
First Line : PO BOX 394
Second Line :
City : HYDE PARK
State : VT
Zip : 05655-0394
Country : US
Telephone Number : 802-730-9086
Fax Number :
Provider Business Practice Location Address
First Line : 200 PARK ST
Second Line :
City : MORRISVILLE
State : VT
Zip : 05661-9098
Country : US
Telephone Number : 802-730-9086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2011
Last Update Date : 01/28/2025

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