Provider Demographics
NPI:1184791162
Name:MCDONALD, RONALD PAUL (DMIN)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:PAUL
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SOUTH AUBURNDALE STREET
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104
Mailing Address - Country:US
Mailing Address - Phone:901-729-3900
Mailing Address - Fax:901-729-2737
Practice Address - Street 1:102 NORTH SECOND STREET
Practice Address - Street 2:SAMARITAN COUNSELING CENTER DOWNTOWN
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103
Practice Address - Country:US
Practice Address - Phone:901-729-3900
Practice Address - Fax:901-729-2737
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLCPT000035101Y00000X
103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist