Provider Demographics
NPI:1487964268
Name:MCDONALD, STEPHANIE ELLEN (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ELLEN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HARRISON AVE # 442
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-9998
Mailing Address - Country:US
Mailing Address - Phone:360-218-4555
Mailing Address - Fax:
Practice Address - Street 1:119 N COMMERCIAL ST STE 940
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4590
Practice Address - Country:US
Practice Address - Phone:360-218-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60421717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health