Provider Demographics
NPI:1063645612
Name:HELLEN G. MCDONALD
Entity Type:Organization
Organization Name:HELLEN G. MCDONALD
Other - Org Name:HELLEN G. MCDONALD COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELLEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-378-8575
Mailing Address - Street 1:44 E MAIN ST
Mailing Address - Street 2:#505
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3636
Mailing Address - Country:US
Mailing Address - Phone:217-378-8575
Mailing Address - Fax:
Practice Address - Street 1:44 E MAIN STREET
Practice Address - Street 2:#505
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820
Practice Address - Country:US
Practice Address - Phone:217-378-8575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490098011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
149.0098901OtherILLINOIS LICENCE TO PRACTICE AS LCSW
11589371OtherCAQH #
IL1932219037OtherTYPE I NPI
214586Medicare UPIN