Provider Demographics
NPI:1992857478
Name:MCDONALD, KARLA (LCPC)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MT
Mailing Address - Zip Code:59003-0047
Mailing Address - Country:US
Mailing Address - Phone:406-784-2346
Mailing Address - Fax:406-784-2711
Practice Address - Street 1:501 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MT
Practice Address - Zip Code:59003-0047
Practice Address - Country:US
Practice Address - Phone:406-784-2346
Practice Address - Fax:406-784-2711
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT755LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT755LCPCOtherSTATE LICENSE