Provider Demographics
NPI:1073660726
Name:GOSNELL, DONNA (MS,MFT, LCADC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:GOSNELL
Suffix:
Gender:F
Credentials:MS,MFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 W CHARLESTON BLVD
Mailing Address - Street 2:STE.140
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1570
Mailing Address - Country:US
Mailing Address - Phone:702-253-6626
Mailing Address - Fax:702-228-9111
Practice Address - Street 1:7331 W CHARLESTON BLVD
Practice Address - Street 2:STE.140
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1570
Practice Address - Country:US
Practice Address - Phone:702-253-6626
Practice Address - Fax:702-228-9111
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV287101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional