Individual provider Active NPI

Sean McDonald, LPC

  • Mental Health Counselor
  • Springdale, AR
National Provider Identifier
1285015677
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P1506060 Issued in AR
Practice address
1672 South 48TH Street
Suite B
Springdale, AR 72762
Phone
(479) 202-6300
Fax
(479) 202-6300
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P1506060 AR Primary

Addresses

Primary practice location

1672 South 48TH Street
Suite B
Springdale, AR 72762

Mailing address

1672 South 48TH Street
Suite B
Springdale, AR 72762
Phone (479) 202-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P1506060ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Waterstone Counseling Center PLLC Mental Health CurrentSince Mar 21, 2021 Accepting new patients

Locations

2002 S 48th St
Ste F
Springdale, AR 72762

1672 S 48th St
#B
Springdale, AR 72762
Phone (479) 202-6300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1285015677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1672 SOUTH 48TH STREET",
            "address_2": "SUITE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72762",
            "telephone_number": "479-202-6300",
            "fax_number": "479-202-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 SOUTH 48TH STREET",
            "address_2": "SUITE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72762",
            "telephone_number": "479-202-6300",
            "fax_number": "479-202-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "SEAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1506060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.