Provider Demographics
NPI:1841832417
Name:MCDONALD, BRANDY G (MSW)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:G
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S LINCOLNWAY STE F
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1597
Mailing Address - Country:US
Mailing Address - Phone:331-308-0054
Mailing Address - Fax:630-801-1675
Practice Address - Street 1:106 S LINCOLNWAY STE F
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1597
Practice Address - Country:US
Practice Address - Phone:331-308-0054
Practice Address - Fax:630-801-1675
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker