Healthcare Provider Details

I. General information

NPI: 1154250611
Provider Name (Legal Business Name): LOTORIUS QUANTAE MCDONALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S LAWRENCE ST
ROCKINGHAM NC
28379-3761
US

IV. Provider business mailing address

380 GREEN LAKE RD
ROCKINGHAM NC
28379-7848
US

V. Phone/Fax

Practice location:
  • Phone: 910-719-4005
  • Fax:
Mailing address:
  • Phone: 910-825-2943
  • Fax: 910-825-2943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: