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General NPI Number Information
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NPI Number | 1730301938
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Entity Type | Individual
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Provider Name | PATRICIA B MACDONALD LCPC, RN
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 884 BROADWAY
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-4371
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Country | US
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Telephone | 207-776-0533
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Fax | 207-767-2327
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Provider Business Mailing Address
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Address Line | PO BOX 7242
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City | PORTLAND
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State | ME
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Zip | 04112-7242
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Country | US
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Telephone | 207-776-0533
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Fax | 207-767-2327
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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 | CC3207
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R028007
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License Number State | ME
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