Healthcare Provider Details

I. General information

NPI: 1972519957
Provider Name (Legal Business Name): WDANIEL MCDONALD MSSW, LISW-S, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 TEMBLETHURST RD
SOUTH EUCLID OH
44121-3716
US

IV. Provider business mailing address

1940 TEMBLETHURST RD
SOUTH EUCLID OH
44121-3716
US

V. Phone/Fax

Practice location:
  • Phone: 614-256-4342
  • Fax:
Mailing address:
  • Phone: 614-256-4342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05918100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI6048-SUPV
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number088945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: