MEDICARE: MARTHA RUTH MCDONALD MA, LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C.1500417	OH

General Provider Information

NPI Number	:	1194225003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA RUTH MCDONALD MA, LPCC

Provider Business Mailing Address
First Line	:	7300 WHIPPLE AVE NW STE 2
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-7159
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	843 N CLEVELAND MASSILLON RD
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-2184
Country	:	US
Telephone Number	:	330-723-7977
Fax Number	:	330-239-8599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2018
Last Update Date	:	03/05/2020

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