Provider Demographics
NPI:1316262967
Name:DONOVAN, CATHY (LCSW)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 ENGEL AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-4357
Mailing Address - Country:US
Mailing Address - Phone:702-339-0346
Mailing Address - Fax:
Practice Address - Street 1:5852 S PECOS RD
Practice Address - Street 2:STE 4
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3489
Practice Address - Country:US
Practice Address - Phone:702-339-0346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2556C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical