Provider Demographics
NPI:1487040648
Name:MACDONALD, CHRIS (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E 5TH ST
Mailing Address - Street 2:P.O. BOX 711
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-2206
Mailing Address - Country:US
Mailing Address - Phone:316-283-6743
Mailing Address - Fax:316-283-6830
Practice Address - Street 1:325 SW FRAZIER AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606
Practice Address - Country:US
Practice Address - Phone:785-232-5005
Practice Address - Fax:888-978-5038
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8053104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100106710Medicaid