Mahan, Donna Jo

Mahan, Donna Jo is an sole proprietor health care provider with primary practice located at 1 Trillium Way , Corbin KY 40701-8727. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Mahan, Donna Jo can be contacted via phone (606) 523-8779.

Contact Information

Primary practice address
1 Trillium Way Corbin KY 40701-8727
Phone: (606) 523-8779
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X 0626 Kentucky

Profile Details

NPI number 1093148884
LBN Legal business name Mahan, Donna Jo
Credentials LPCC, CADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2013
Last updated Mar 11th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093148884 NPPES
Kentucky MEDICAID 7100282390

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