Provider Demographics
NPI:1215745732
Name:MACDONALD, ELIZABETH (LAPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CANDO
Mailing Address - State:ND
Mailing Address - Zip Code:58324-6109
Mailing Address - Country:US
Mailing Address - Phone:701-230-9394
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1207
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:ND
Practice Address - Zip Code:58367-1207
Practice Address - Country:US
Practice Address - Phone:701-641-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1418-1-1-25A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional