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General NPI Number Information
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NPI Number | 1689779944
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Entity Type | Individual
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Provider Name | MATTHEW LEE MCDONALD PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 3255 W 26TH ST
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City | ERIE
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State | PA
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Zip | 16506-2507
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Country | US
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Telephone | 814-836-8888
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Fax | 814-836-8880
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Provider Business Mailing Address
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Address Line | 6155 INVERNESS TER
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City | FAIRVIEW
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State | PA
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Zip | 16415-3279
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Country | US
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Telephone | 814-490-8081
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Fax | 814-836-8880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC003384
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS016423
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License Number State | PA
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