Provider Demographics
NPI:1881367845
Name:MCDONALD, KARI MCDONALD LINDSAY
Entity type:Individual
Prefix:
First Name:KARI MCDONALD
Middle Name:LINDSAY
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 TREASURE BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLET
Mailing Address - State:GA
Mailing Address - Zip Code:30415-8223
Mailing Address - Country:US
Mailing Address - Phone:912-856-2527
Mailing Address - Fax:
Practice Address - Street 1:8400 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3425
Practice Address - Country:US
Practice Address - Phone:912-200-4775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA862421422Medicaid