Provider Demographics
NPI:1306077706
Name:SHEALY, DONNA MURPHY (PHD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MURPHY
Last Name:SHEALY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 MARTINS CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:SC
Mailing Address - Zip Code:29054-8673
Mailing Address - Country:US
Mailing Address - Phone:803-892-7245
Mailing Address - Fax:
Practice Address - Street 1:606 NORTHWOOD RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2130
Practice Address - Country:US
Practice Address - Phone:803-730-2339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2107101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional