Provider Demographics
NPI:1467963314
Name:MCDONALD, AISHA T (LMHC)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:T
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7064 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5202
Mailing Address - Country:US
Mailing Address - Phone:954-681-2244
Mailing Address - Fax:
Practice Address - Street 1:7064 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-5202
Practice Address - Country:US
Practice Address - Phone:954-681-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health