MEDICARE: RUSSELL MCDONALD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	A22964	NC

General Provider Information

NPI Number	:	1427983840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL MCDONALD

Provider Business Mailing Address
First Line	:	518 PANTHERS RUN DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-9185
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	518 PANTHERS RUN DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-9185
Country	:	US
Telephone Number	:	215-584-5812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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Directions to “ RUSSELL MCDONALD ” Practice Location

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