Organization
MARSHA MCDONALD, MSW, LICSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARSHA BERNADETTE MCDONALD MSW, LICSW (CHIEF MANAGER, TREASURER AND SECRET)
(952) 285-2917
Entity
Organization
Contact information
Practice address
4005 W 65TH ST, 122, EDINA, MN 55435-1720
(952) 285-2917
Mailing address
4005 W 65TH ST, 122, EDINA, MN 55435-1720
(952) 285-2917
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14892
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258P4MC
BLUECROSS BLUE SHIELD
MN
01
—
6271149
MEDICA
MN
Enumeration date
08/19/2006
Last updated
08/22/2020
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