Individual
GRACE LOUISE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDCII
Contact information
Practice address
247 CIC BLVD, WEST UNION, OH 45693-7512
(513) 941-4999
Mailing address
6460 HARRISON AVE STE 200, CINCINNATI, OH 45247-7958
(513) 941-4999
(513) 694-0168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.163682
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.166796
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCII.161498
OH
101YM0800X
Mental Health Counselor
QMHS.3
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0319180
—
OH
01
—
163682
OHIO LICENSE
OH
Enumeration date
06/06/2017
Last updated
02/28/2024
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