Provider Demographics
NPI:1720725047
Name:MCDONALD, EVELYN CHRISTINE (CADACII, ICADC)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:CHRISTINE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CADACII, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 RAVINIA AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-1344
Mailing Address - Country:US
Mailing Address - Phone:179-384-2463
Mailing Address - Fax:
Practice Address - Street 1:208 RAVINIA AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-1344
Practice Address - Country:US
Practice Address - Phone:317-938-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC-1955101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)