Provider Demographics
NPI:1235666561
Name:DONALDSON, ANDREW R (MA, LLPC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CASCADE WEST PKWY SE STE 240
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2166
Mailing Address - Country:US
Mailing Address - Phone:616-591-9000
Mailing Address - Fax:616-591-9060
Practice Address - Street 1:500 CASCADE WEST PKWY SE STE 240
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2166
Practice Address - Country:US
Practice Address - Phone:616-591-9000
Practice Address - Fax:616-591-9060
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015740101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional