Provider Demographics
NPI:1972731578
Name:MACDONALD, LORNA SHALA (MHP)
Entity Type:Individual
Prefix:MR
First Name:LORNA
Middle Name:SHALA
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:MRS
Other - First Name:LORNA
Other - Middle Name:SHALA
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2420 LINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-6122
Mailing Address - Country:US
Mailing Address - Phone:870-972-1268
Mailing Address - Fax:
Practice Address - Street 1:2420 LINWOOD DR
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-6122
Practice Address - Country:US
Practice Address - Phone:870-972-1268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor