Provider Demographics
NPI:1609558709
Name:MCDONALD, WINSTON LOCKER (MA, ALC)
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:LOCKER
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MA, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SANDERS ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-1420
Mailing Address - Country:US
Mailing Address - Phone:256-497-1790
Mailing Address - Fax:
Practice Address - Street 1:202 SANDERS ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-1420
Practice Address - Country:US
Practice Address - Phone:256-497-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04549101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health