Provider Demographics
NPI:1033861844
Name:MCDONALD, MICHAEL (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-4354
Mailing Address - Country:US
Mailing Address - Phone:443-986-2000
Mailing Address - Fax:
Practice Address - Street 1:76 MAMARONECK AVE STE 16
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4226
Practice Address - Country:US
Practice Address - Phone:914-288-5294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health