Provider Demographics
NPI:1093916413
Name:MCDONALD, JOANN BURTON (MSW)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:BURTON
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 35TH STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207
Mailing Address - Country:US
Mailing Address - Phone:703-534-0488
Mailing Address - Fax:
Practice Address - Street 1:5276 DAWES AVE
Practice Address - Street 2:POTOMAC CENTER
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311
Practice Address - Country:US
Practice Address - Phone:703-379-7350
Practice Address - Fax:703-379-7352
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALCSW 09040036191041C0700X
DCLICSW LC3028961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical