Active NPI
Shane Michael McDonald, MS, LMHC
- Mental Health Counselor
- Orlando, FL
National Provider Identifier
1922684810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH18922
- Practice address
- 4700 Millenia Blvd Ste 175
Orlando, FL 32839-6015 - Phone
- (407) 803-5261
- NPI assigned
- Mar 22, 2021
- Last updated
- Mar 22, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH18922 | FL | Primary |
Addresses
Primary practice location
4700 Millenia Blvd Ste 175
Orlando, FL 32839-6015
Mailing address
1602 Whitefriar Dr
Ocoee, FL 34761
Phone (407) 802-9011
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH18922 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1922684810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1602 WHITEFRIAR DR",
"city": "OCOEE",
"state": "FL",
"postal_code": "34761",
"telephone_number": "407-802-9011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 MILLENIA BLVD STE 175",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328396015",
"telephone_number": "407-803-5261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "SHANE",
"middle_name": "MICHAEL",
"credential": "MS, LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-22",
"last_updated": "2021-03-22",
"certification_date": "2021-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH18922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.