NPI Code Details Logo

NPI 1417494469

NPI 1417494469 : MICHELLE MCDONALD PHD : LEONARDTOWN, MD

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1417494469
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MICHELLE MCDONALD PHD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/30/2017
-----------------------------------------------------
    Last Update Date     |    12/15/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    40900 MERCHANTS LN UNIT 207 
-----------------------------------------------------
    City                 |    LEONARDTOWN
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20650-3796
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    518-369-5282
-----------------------------------------------------
    Fax                  |    301-560-4954
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    40900 MERCHANTS LN UNIT 207 
-----------------------------------------------------
    City                 |    LEONARDTOWN
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20650-3796
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    518-369-5282
-----------------------------------------------------
    Fax                  |    301-560-4954
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103T00000X
-----------------------------------------------------
    Taxonomy Name        |    Psychologist
-----------------------------------------------------
    License Number       |    PY9795
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    103TC0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Psychologist
-----------------------------------------------------
    License Number       |    07467
-----------------------------------------------------
    License Number State |    MD
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.