Healthcare Provider Details

I. General information

NPI: 1427595727
Provider Name (Legal Business Name): PATSY MCDONALD LICDC-CS, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 UNDERWOOD ST
ZANESVILLE OH
43701-3771
US

IV. Provider business mailing address

601 UNDERWOOD ST
ZANESVILLE OH
43701-3771
US

V. Phone/Fax

Practice location:
  • Phone: 740-454-1266
  • Fax: 740-454-7650
Mailing address:
  • Phone: 740-454-1266
  • Fax: 740-454-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number943873
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS12692
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: