Provider Demographics
NPI:1174285969
Name:HOLLAND MCDONALD, MEGHAN LESLIE (LGPC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LESLIE
Last Name:HOLLAND MCDONALD
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7704
Mailing Address - Country:US
Mailing Address - Phone:617-319-0271
Mailing Address - Fax:
Practice Address - Street 1:807 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7704
Practice Address - Country:US
Practice Address - Phone:617-319-0271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional