Provider Demographics
NPI:1467982512
Name:MCDONALD, BETH KAY (LPC)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:KAY
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 FEDERAL DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1337
Mailing Address - Country:US
Mailing Address - Phone:651-560-0050
Mailing Address - Fax:651-925-0257
Practice Address - Street 1:3410 FEDERAL DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1337
Practice Address - Country:US
Practice Address - Phone:651-560-0050
Practice Address - Fax:651-925-0257
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009499101YP2500X
MNLPCC3270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional