Provider Demographics
NPI:1891251070
Name:MCDANAL, JOHN T (MED, ALC, NCC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:T
Last Name:MCDANAL
Suffix:
Gender:M
Credentials:MED, ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5104 WEATHERFORD DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3258
Mailing Address - Country:US
Mailing Address - Phone:205-240-3997
Mailing Address - Fax:
Practice Address - Street 1:3 OFFICE PARK CIR STE 105
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2534
Practice Address - Country:US
Practice Address - Phone:205-240-3997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2789A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health