Provider Demographics
NPI:1174641195
Name:MCDONALD, KATHLEEN (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 E BALTIMORE PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1800
Mailing Address - Country:US
Mailing Address - Phone:610-388-7400
Mailing Address - Fax:
Practice Address - Street 1:920 E BALTIMORE PIKE STE 200
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1800
Practice Address - Country:US
Practice Address - Phone:610-388-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018184103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical