Catherine a. McDonald

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7789 Issued in MN

Legal business name

CATHERINE A. MCDONALD

Practice address

412 N Pokegama Ave Ste 16
Grand Rapids, MN 55744-2684

Phone

(218) 326-3390

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Catherine A McDonald, LICSW

Title

Owner

Phone

(218) 326-3390

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1699859199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N POKEGAMA AVE STE 16",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N POKEGAMA AVE STE 16",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442684",
            "telephone_number": "218-326-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHERINE A. MCDONALD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-326-3390",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "7789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132327000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ID",
            "identifier": "6265929",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "179M6MC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "488857",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack Victor Carlisle, MD
• Dawn Carlson
• Donald M Carlson, PT
• Jeremy Todd Carlson, M.D.
• Natalie Jo Castle, PA-C
• Grace Elizabeth Chang, LICSW
• Childrens Mental Health Service Reach
• Childrens Mental Health Services Reach
• Heidi Raquel Childs
• Suzette Childs, RN BSN CDE CPT

• Clinical Social Worker in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.