Provider Demographics
NPI:1740628924
Name:MCDONALD, CHRISTINE (LPCS)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7785 FALCON REST CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2553
Mailing Address - Country:US
Mailing Address - Phone:919-618-6526
Mailing Address - Fax:
Practice Address - Street 1:314 W MILLBROOK RD STE 21
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4380
Practice Address - Country:US
Practice Address - Phone:919-618-6526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA7801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional