Individual
BRENNA CATHLEEN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
545 BARNHILL DR, EH 125, INDIANAPOLIS, IN 46202-5112
(317) 274-8800
(317) 274-2384
Mailing address
545 BARNHILL DR, EH 125, INDIANAPOLIS, IN 46202-5112
(317) 274-8800
(317) 274-2384
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20042155A
IN
103G00000X
Clinical Neuropsychologist
985
NH
103T00000X
Psychologist
20042155A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000627907
ANTHEM PTAN
IN
01
—
1009013
MEDICAID
VT
05
—
200853990
—
IN
05
—
30422169
—
NH
Enumeration date
12/01/2006
Last updated
02/13/2025
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