MEDICARE: WDANIEL MCDONALD MSSW, LISW-S, 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
1	1041C0700X	Clinical Social Worker	44SC05918100	NJ
2	1041C0700X	Clinical Social Worker	I6048-SUPV	OH
3	1041C0700X	Clinical Social Worker	088945	NY

General Provider Information

NPI Number	:	1972519957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WDANIEL MCDONALD MSSW, LISW-S, LCSW

Provider Business Mailing Address
First Line	:	2331 MILTON RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3968
Country	:	US
Telephone Number	:	201-907-7251
Fax Number	:

Provider Business Practice Location Address
First Line	:	2331 MILTON RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3968
Country	:	US
Telephone Number	:	201-907-7251
Fax Number	:

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	10/28/2025

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