Provider Demographics
NPI:1346974219
Name:MACDONALD, DANIEL (LPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915 GATE BRG
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3882
Mailing Address - Country:US
Mailing Address - Phone:631-805-6341
Mailing Address - Fax:
Practice Address - Street 1:7915 GATE BRG
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:TX
Practice Address - Zip Code:78154-3882
Practice Address - Country:US
Practice Address - Phone:631-805-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health