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MAXINE MCDONALD LCSW-R, CASAC

Addiction Substance Use Disorder

Ontario, New York

Provider NPI: 1609831106

Provider Information:
 MAXINE  MCDONALD LCSW-R, CASAC
Gender: F


Practice Location:
2139 EVERGREEN LN  ONTARIO, NY 14519 US
Tel: 585-330-8891  Fax: --

Business Mailing Address:
2139 EVERGREEN LN  ONTARIO, NY 14519 US
Tel: 585-330-8891  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
NY5134
X1041C0700XBehavioral Health & Social Service Providers
Social Worker
NYR042699-1

Other Provider Identifiers:

IssuerNumberStateType
PREFERRED CARE110547FKNY01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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