Provider Demographics
NPI:1902854581
Name:MCBRIDE, LADONNA R (LCSW, ACSW)
Entity Type:Individual
Prefix:MR
First Name:LADONNA
Middle Name:R
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 TOPHILL LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4481
Mailing Address - Country:US
Mailing Address - Phone:972-691-9601
Mailing Address - Fax:
Practice Address - Street 1:2905 TOPHILL LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4481
Practice Address - Country:US
Practice Address - Phone:972-691-9601
Practice Address - Fax:972-820-8200
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88623QOtherBCBS TX
TXTXB133793Medicare PIN
TXTX33228Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER