Provider Demographics
NPI:1598120958
Name:MACDONALD, JOHN A (JD, MA,NCC,LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:MACDONALD
Suffix:
Gender:M
Credentials:JD, MA,NCC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 US HIGHWAY 130
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-2207
Mailing Address - Country:US
Mailing Address - Phone:609-759-2074
Mailing Address - Fax:732-431-5300
Practice Address - Street 1:691 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-2207
Practice Address - Country:US
Practice Address - Phone:609-759-2074
Practice Address - Fax:609-759-2074
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00263500101Y00000X
NJ37PC00792000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor