Provider Demographics
NPI:1386975944
Name:LOCKE, DONNA S (LCSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:LOCKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:235 MEADOW DR
Mailing Address - Street 2:SUITE 20
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3764
Mailing Address - Country:US
Mailing Address - Phone:541-301-2972
Mailing Address - Fax:541-488-0018
Practice Address - Street 1:1245 N RIVERSIDE AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-4655
Practice Address - Country:US
Practice Address - Phone:541-301-2972
Practice Address - Fax:541-857-1204
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR29731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical