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Individual

JONATHAN MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, MFTA

Contact information

Practice address
633 BAXTER AVE, LOUISVILLE, KY 40204-1157
(502) 309-2408
Mailing address
4006 ELFIN AVE, LOUISVILLE, KY 40207-2024
(502) 650-0041

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
259653
KY
106H00000X
Marriage & Family Therapist
266471
KY

Other

Enumeration date
09/20/2024
Last updated
09/20/2024
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