Individual
MR. JOSEPH DISTER MCDONNELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, LCDP
Contact information
Practice address
162 TERRACE AVE, RIVERSIDE, RI 02915-4727
(401) 829-2332
Mailing address
162 TERRACE AVE, RIVERSIDE, RI 02915-4727
(401) 829-2332
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDP00277
RI
101YM0800X
Mental Health Counselor
1601
NE
Other
Enumeration date
12/09/2005
Last updated
09/11/2025
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