Provider Demographics
NPI:1366893802
Name:MCDONALD, KATHRINE (CAADC)
Entity type:Individual
Prefix:
First Name:KATHRINE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 PEBBLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3241
Mailing Address - Country:US
Mailing Address - Phone:215-547-1440
Mailing Address - Fax:215-547-4054
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUITE 403A
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-638-5266
Practice Address - Fax:215-946-4353
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACAADC9557101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9557OtherCAADC