Provider Demographics
NPI:1962575274
Name:TOTTEN, DONALD LEO (LP)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LEO
Last Name:TOTTEN
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MAPLE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307
Mailing Address - Country:US
Mailing Address - Phone:231-796-8881
Mailing Address - Fax:231-796-8881
Practice Address - Street 1:211 MAPLE
Practice Address - Street 2:TOTTEN PSYCHOLOGICAL SERVICES
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307
Practice Address - Country:US
Practice Address - Phone:231-796-8881
Practice Address - Fax:231-796-8881
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009768103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP107387OtherBLUE CARE NETWORK
MI096858OtherVALUE OPTIONS
MI5969649OtherAETNA
MIPH14728OtherPRIORITY HEALTH
MI68DE445040OtherBCBS
6301009768OtherMICHIGAN LICENSE NO
MIIP538311OtherUNITED BEHAVIORAL HEALTH
6301009768OtherMICHIGAN LICENSE NO
MIIP538311OtherUNITED BEHAVIORAL HEALTH