Individual provider Active NPI

Terri Lynn McDonald, LCSW

  • Clinical Social Worker
  • Leesburg, FL
National Provider Identifier
1891347548
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16393 Issued in FL
Practice address
2018 Talley Rd
Leesburg, FL 34748-3426
Phone
(352) 315-7400
Fax
(352) 360-6656
NPI assigned
Jul 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW16393 FL Primary

Addresses

Primary practice location

2018 Talley Rd
Leesburg, FL 34748-3426

Mailing address

PO Box 491000
Leesburg, FL 34749-1000
Phone (352) 315-7500

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
SW16393FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestream Behavioral Center Inc Past Accepting new patients
Lifestream Behavioral Center Inc Past Accepting new patients

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": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1891347548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491000",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347491000",
            "telephone_number": "352-315-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 TALLEY RD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483426",
            "telephone_number": "352-315-7400",
            "fax_number": "352-360-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TERRI",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.