Provider Demographics
NPI:1366716938
Name:DONOVAN, BETH B (LPCMH)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:B
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:B
Other - Last Name:BREDIMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCMH
Mailing Address - Street 1:410 FOULK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3835
Mailing Address - Country:US
Mailing Address - Phone:302-530-9520
Mailing Address - Fax:
Practice Address - Street 1:1053 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-8060
Practice Address - Country:US
Practice Address - Phone:302-530-9520
Practice Address - Fax:610-279-7156
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health