Provider Demographics
NPI:1144556531
Name:MCDONALD, KATHRYN LADEAN (MS, PLMHP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LADEAN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MS, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 NANCE ST # 636
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:NE
Mailing Address - Zip Code:68307-4011
Mailing Address - Country:US
Mailing Address - Phone:402-306-4687
Mailing Address - Fax:
Practice Address - Street 1:722 E COURT ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-3928
Practice Address - Country:US
Practice Address - Phone:402-223-3843
Practice Address - Fax:402-223-4200
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8832101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health