Healthcare Provider Details

I. General information

NPI: 1043132459
Provider Name (Legal Business Name): NICOLA C MCDONALD MSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 KENSINGTON RD
BLOOMFIELD HILLS MI
48304-1830
US

IV. Provider business mailing address

360 DONEGAL DR
ROCHESTER HILLS MI
48309-1225
US

V. Phone/Fax

Practice location:
  • Phone: 248-341-7308
  • Fax:
Mailing address:
  • Phone: 847-533-2412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801095905
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: