Provider Demographics
NPI:1528257672
Name:FESPERMAN, DONNA SMITH (LPC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:SMITH
Last Name:FESPERMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WALNUT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-9762
Mailing Address - Country:US
Mailing Address - Phone:704-888-0077
Mailing Address - Fax:
Practice Address - Street 1:105 WALNUT CREEK RD
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-9762
Practice Address - Country:US
Practice Address - Phone:704-888-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC427101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool