Provider Demographics
NPI:1972519957
Name:MCDONALD, WDANIEL (MSSW, LISW-S, LCSW)
Entity Type:Individual
Prefix:
First Name:WDANIEL
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MSSW, LISW-S, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BRIARCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4005
Mailing Address - Country:US
Mailing Address - Phone:201-907-7251
Mailing Address - Fax:
Practice Address - Street 1:21 BRIARCLIFFE RD
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4005
Practice Address - Country:US
Practice Address - Phone:201-907-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0889451041C0700X
OHI6048-SUPV1041C0700X
NJ44SC059181001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical