Provider Demographics
NPI:1174873830
Name:DIRE, DONNA JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:DIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:JEAN
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:645 ROLLING MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-2419
Mailing Address - Country:US
Mailing Address - Phone:724-627-3108
Mailing Address - Fax:
Practice Address - Street 1:645 ROLLING MEADOWS RD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-2419
Practice Address - Country:US
Practice Address - Phone:724-627-3108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW006347L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical