Provider Demographics
NPI:1225658834
Name:MCDONALD, MARY CLAIRE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CLAIRE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:CLAIRE
Other - Middle Name:MCDONALD
Other - Last Name:OLBRYCHOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:4591 CLUB VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4347
Mailing Address - Country:US
Mailing Address - Phone:818-825-8593
Mailing Address - Fax:
Practice Address - Street 1:4591 CLUB VIEW DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4347
Practice Address - Country:US
Practice Address - Phone:818-825-8593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist