Provider Demographics
NPI:1104952613
Name:DONAGHUE, ELAINE P (RN LCSW ACSW)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:P
Last Name:DONAGHUE
Suffix:
Gender:F
Credentials:RN LCSW ACSW
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Mailing Address - Street 1:3 HARBOUR DRIVE SOUTH BLDG TWO
Mailing Address - Street 2:
Mailing Address - City:OCEAN RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-732-5006
Mailing Address - Fax:561-736-8224
Practice Address - Street 1:115 W WOOLBRIGHT RD BLDG 2
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5908
Practice Address - Country:US
Practice Address - Phone:561-732-5006
Practice Address - Fax:561-736-8224
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSW44221041C0700X
FLRN579382163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered163W00000XNursing Service ProvidersRegistered Nurse