Provider Demographics
NPI:1346518859
Name:MACDONALD, CATHERINE ANN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:PORTHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:5200 WILLSON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1332
Mailing Address - Country:US
Mailing Address - Phone:612-803-5546
Mailing Address - Fax:952-920-2461
Practice Address - Street 1:5200 WILLSON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1332
Practice Address - Country:US
Practice Address - Phone:612-803-5546
Practice Address - Fax:952-920-2461
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1683106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist