Provider Demographics
NPI:1760976161
Name:MCDONALD, MARIA C (MA, LPC, SAC)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MA, LPC, SAC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:C
Other - Last Name:HAMEISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7633 GANSER WAY STE 204
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7633 GANSER WAY STE 204
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2092
Practice Address - Country:US
Practice Address - Phone:608-829-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16426-131101YA0400X
WI7805-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)