Provider Demographics
NPI:1598866329
Name:DONOVAN, CELIA (LMHC LCDP CCDP RCS)
Entity type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LMHC LCDP CCDP RCS
Other - Prefix:
Other - First Name:CELIA
Other - Middle Name:A
Other - Last Name:WINSOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 BESTWICK TRL
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-6061
Mailing Address - Country:US
Mailing Address - Phone:401-323-8297
Mailing Address - Fax:
Practice Address - Street 1:33 COLLEGE HILL RD STE 30E
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2767
Practice Address - Country:US
Practice Address - Phone:401-821-6070
Practice Address - Fax:401-821-6047
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
RILCDP00359101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICW61824Medicaid