Provider Demographics
NPI:1215501499
Name:MCDONALD, RYAN (LPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 BUFFALO GAP RD STE 2900
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2723
Mailing Address - Country:US
Mailing Address - Phone:325-261-3074
Mailing Address - Fax:
Practice Address - Street 1:4400 BUFFALO GAP RD STE 2900
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2723
Practice Address - Country:US
Practice Address - Phone:325-261-3074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89956101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health