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NPI Code Detail

MEDICARE: ROBERT A MCDONALD LCSW

MEDICARE: ROBERT A MCDONALD LCSW
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
1104100000XSocial Worker005044MO
21041C0700XClinical Social Worker005044MO

General Provider Information

NPI Number : 1396723912
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT A MCDONALD LCSW
Provider Business Mailing Address
First Line : 1500 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-3318
Country : US
Telephone Number : 573-778-4792
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-3318
Country : US
Telephone Number : 573-778-4792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 02/24/2014

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Directions to “ ROBERT A MCDONALD LCSW” Practice Location

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