Provider Demographics
NPI:1376578989
Name:MCDONALD, NANCY M (LMSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S BURDICK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5221
Mailing Address - Country:US
Mailing Address - Phone:269-381-3700
Mailing Address - Fax:269-381-3810
Practice Address - Street 1:610 S BURDICK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5221
Practice Address - Country:US
Practice Address - Phone:269-381-3700
Practice Address - Fax:269-381-3810
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17643021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical