Provider Demographics
NPI:1649526161
Name:MCDONALD, SARAH C (LMHC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:M
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:5 HEMPHILL PLACE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4423
Mailing Address - Country:US
Mailing Address - Phone:518-289-5072
Mailing Address - Fax:518-289-5225
Practice Address - Street 1:5 HEMPHILL PLACE
Practice Address - Street 2:SUITE 121
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-4423
Practice Address - Country:US
Practice Address - Phone:518-289-5072
Practice Address - Fax:518-289-5225
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18 005206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FIDELISOther051104000053
NY02664359Medicaid