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NPI Code Detail

MEDICARE: JACOB AARON MCDONALD LCPC

MEDICARE: JACOB AARON MCDONALD LCPC
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
1101YM0800XMental Health CounselorLC16278MD

General Provider Information

NPI Number : 1518606573
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB AARON MCDONALD LCPC
Provider Business Mailing Address
First Line : 11 BYTE CT STE C
Second Line :
City : FREDERICK
State : MD
Zip : 21702-8718
Country : US
Telephone Number : 405-902-5703
Fax Number :
Provider Business Practice Location Address
First Line : 11 BYTE CT STE C
Second Line :
City : FREDERICK
State : MD
Zip : 21702-8718
Country : US
Telephone Number : 240-285-9807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2022
Last Update Date : 03/16/2025

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