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General NPI Number Information
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NPI Number | 1932537594
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Entity Type | Organization
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Legal Business Name | ELIZABETH MCDONALD PROFESSIONAL COUNSELING, LLC
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Dates
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Enumeration Date | 10/17/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 216 E FRONT ST SUITE 203
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-5736
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Country | US
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Telephone | 989-239-0589
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Fax |
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Provider Business Mailing Address
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Address Line | 139 CLARE BLVD
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City | ROSCOMMON
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State | MI
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Zip | 48653-9540
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Country | US
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Telephone | 989-239-0589
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH ANN MCDONALD
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Credential | LPC
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Telephone | 989-239-0589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401003321
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License Number State | MI
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