Provider Demographics
NPI:1417103391
Name:MCDONALD, NANCY D (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:D
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 STILLMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-6100
Mailing Address - Country:US
Mailing Address - Phone:256-497-3147
Mailing Address - Fax:
Practice Address - Street 1:725 W MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2456
Practice Address - Country:US
Practice Address - Phone:256-497-1790
Practice Address - Fax:256-998-5500
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AL2342C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health