Provider Demographics
NPI:1184781692
Name:MCDONALD, PATRICIA PARKS (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:PARKS
Last Name:MCDONALD
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3081 BERGEN PEAK DR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-2200
Mailing Address - Country:US
Mailing Address - Phone:303-674-6400
Mailing Address - Fax:
Practice Address - Street 1:3721 EVERGREEN PKWY
Practice Address - Street 2:SUITE 10
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80437
Practice Address - Country:US
Practice Address - Phone:303-670-4280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9894351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO003380426Medicare UPIN