Provider Demographics
NPI:1588444038
Name:HIDALGO, DONNA A (LCSW, C-SSWS)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:A
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:LCSW, C-SSWS
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:A
Other - Last Name:ELKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, C-SSWS
Mailing Address - Street 1:2500 VIKING DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2104
Mailing Address - Country:US
Mailing Address - Phone:318-549-6129
Mailing Address - Fax:318-549-6122
Practice Address - Street 1:2500 VIKING DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2104
Practice Address - Country:US
Practice Address - Phone:318-549-6129
Practice Address - Fax:318-549-6122
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61991041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool