Basic Information
| Provider Information | |||||||||
| NPI: | 1588777205 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDONALD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MS. LPC. CSAC.CACIII | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 HOPE RD | ||||||||
| Address2: | STAFFORD FAMILY COUNSELING STE 213 | ||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225547287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406580888 | ||||||||
| FaxNumber: | 5406580855 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 HOPE RD | ||||||||
| Address2: | STAFFORD FAMILY COUNSELING STE 213 | ||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225547287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406580888 | ||||||||
| FaxNumber: | 5406580855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 06/18/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 5801 | CO | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 2592 | CO | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 0701005106 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YA0400X | 0710102751 | VA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.