Provider Demographics
NPI:1073645198
Name:MASTERSON, DONNA JOSEPHINE (LCDC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:JOSEPHINE
Last Name:MASTERSON
Suffix:
Gender:
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 W HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3718
Mailing Address - Country:US
Mailing Address - Phone:325-947-7729
Mailing Address - Fax:325-947-9755
Practice Address - Street 1:2307 W HARRIS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3718
Practice Address - Country:US
Practice Address - Phone:325-947-7729
Practice Address - Fax:325-947-9755
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)