Provider Demographics
NPI:1780727388
Name:MCDONALD, CLAUDETTE M (LISW)
Entity type:Individual
Prefix:MRS
First Name:CLAUDETTE
Middle Name:M
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 HICKMAN RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4843
Mailing Address - Country:US
Mailing Address - Phone:515-276-3355
Mailing Address - Fax:
Practice Address - Street 1:7025 HICKMAN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-4843
Practice Address - Country:US
Practice Address - Phone:515-276-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00506104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker