Provider Demographics
NPI:1255038071
Name:MCDONALD, LEXI SUZANNE (MS, LPCC)
Entity type:Individual
Prefix:
First Name:LEXI
Middle Name:SUZANNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25327 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:ZIMMERMAN
Mailing Address - State:MN
Mailing Address - Zip Code:55398-4735
Mailing Address - Country:US
Mailing Address - Phone:763-639-0164
Mailing Address - Fax:
Practice Address - Street 1:15243 NOWTHEN BLVD NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-6138
Practice Address - Country:US
Practice Address - Phone:612-900-0233
Practice Address - Fax:888-705-2374
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC3665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health