Provider Demographics
NPI:1548366214
Name:DONOVAN, MARGARET A (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:DONOVAN
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 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 N 175TH ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3515
Practice Address - Country:US
Practice Address - Phone:402-596-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE508103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47080527026Medicaid
NE206499000OtherMAGELLAN
NE08258OtherBCBS
NE280524Medicare ID - Type Unspecified