Individual provider Active NPI

Clinton Taylor Donaldson, MA, LPC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1700304607
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74400 Issued in TX
Practice address
4305 Macarthur Ave
Dallas, TX 75209-6511
Phone
(214) 526-4525
Fax
(214) 520-6468
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 74400 TX
Addiction (Substance Use Disorder) Counselor 101YA0400X 74400 TX
Mental Health Counselor 101YM0800X 74400 TX
Professional Counselor 101YP2500X 74400 TX Primary

Addresses

Primary practice location

4305 Macarthur Ave
Dallas, TX 75209-6511

Mailing address

4305 Macarthur Ave
Dallas, TX 75209-6511
Phone (214) 526-4525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125001350 TX Practitioner - Mental Health Counselor 6800249947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Center for Integrative Counseling and PsychologyGroup PAC ID 8527111731, 33 clinicians

Practice addresses (Care Compare)

4305 Macarthur Ave
Dallas, TX 75209-6511
Phone (214) 526-4525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
74400TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Integrative Counseling and Psychology CurrentSince Jan 1, 2024 Accepting new patients
Stonegate Center, LLC PastSince Feb 23, 2020 Accepting new patients

Locations

4100 N Collins St
Arlington, TX 76005

4305 MacArthur Ave
Dallas, TX 75209

4525 Lemmon Ave
Ste 200
Dallas, TX 75219

2520 Oates Dr
Mesquite, TX 75150

Organizations & group practices 2

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1700304607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 MACARTHUR AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752096511",
            "telephone_number": "214-526-4525",
            "fax_number": "214-520-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 MACARTHUR AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752096511",
            "telephone_number": "214-526-4525",
            "fax_number": "214-520-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "CLINTON",
        "middle_name": "TAYLOR",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "74400",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "74400",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "74400",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.