Provider Demographics
NPI:1982613220
Name:MACDONALD, DAVID J (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:MACDONALD
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:GERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28735-0133
Mailing Address - Country:US
Mailing Address - Phone:828-348-9565
Mailing Address - Fax:
Practice Address - Street 1:1095 HENDERSONVILLE RD
Practice Address - Street 2:SUITE I
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1891
Practice Address - Country:US
Practice Address - Phone:828-348-9565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0012461041C0700X
NCC0057121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAS52766Medicare UPIN