Provider Demographics
NPI:1407636780
Name:MCDONALD, CHRISTOPHER LE'ROY (MED LPC, LCDC, NCC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LE'ROY
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MED LPC, LCDC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SOUTHWEST PKWY APT 611
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-4906
Mailing Address - Country:US
Mailing Address - Phone:210-279-3415
Mailing Address - Fax:
Practice Address - Street 1:1600 SOUTHWEST PKWY APT 611
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-4906
Practice Address - Country:US
Practice Address - Phone:210-279-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15503101YA0400X
TX84789101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)