| Doctor Name: | DONNA C FORTNEY |
| NPI Number: | 1104967173 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0701003657 |
| Business Practice Address: | 5675 Stone Rd Suite 300 Centreville, VA - 201201667 |
| Business Phone Number: | 7038693589 |
| Business Fax Number: | 7038189688 |
| Mailing Address: | 14531 Creek Branch Ct, CENTREVILLE |
| State: | VA |
| Postal Code: | 201201382 |
| Phone Number: | 7038693589 |
| Fax Number: | 7038189688 |
| NPI Enumeration Date: | 02/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0701003657 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |