Provider Demographics
NPI:1679072805
Name:MCDONALD, RICHARD (LCMHC, LCAS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1455
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28002-1455
Mailing Address - Country:US
Mailing Address - Phone:704-438-2945
Mailing Address - Fax:704-731-0908
Practice Address - Street 1:723 W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4149
Practice Address - Country:US
Practice Address - Phone:980-330-7000
Practice Address - Fax:704-731-0908
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23604101YA0400X
NC14159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)