Provider Demographics
NPI:1295133031
Name:NEWELL, DONNA LEE (PMHCNS-BC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:NEWELL
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:LEE
Other - Last Name:COSTABILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:110 SOUTHLAKE LN
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3329
Mailing Address - Country:US
Mailing Address - Phone:205-777-8184
Mailing Address - Fax:205-978-7802
Practice Address - Street 1:100 CENTURY PARK S
Practice Address - Street 2:SUITE 206
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-3949
Practice Address - Country:US
Practice Address - Phone:205-978-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-031253364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult