Individual
MR. RONALD GRANT MACDONALD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LISAC
Contact information
Practice address
463 S. LAKE POWELL BLVD, PAGE, AZ 86040-0790
(928) 645-5113
(928) 645-3254
Mailing address
PO BOX 790, PAGE, AZ 86040-0790
(928) 645-5113
(928) 645-3254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-0989
AZ
101YP2500X
Professional Counselor
Primary
LPC-10208
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
832859
—
AZ
Enumeration date
04/19/2006
Last updated
05/14/2014
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