Provider Demographics
NPI:1285917062
Name:MCDONALD, HEIDI C (MMFT, LCMFT)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:C
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MMFT, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 N EXPOSITION ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-5902
Mailing Address - Country:US
Mailing Address - Phone:316-264-8317
Mailing Address - Fax:
Practice Address - Street 1:2604 W 9TH ST N
Practice Address - Street 2:SUITE 205
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4731
Practice Address - Country:US
Practice Address - Phone:316-295-4758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist