Justin Ritchie Macdonald, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC014288 Issued in PA

Practice address

390 Reed Rd FL 1
Broomall, PA 19008-4008

Phone

(484) 450-6476

Fax

(484) 224-3398

NPI assigned

Feb 23, 2022

Last updated

Jul 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Spectra Support Services, LLC

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1134482409

  Mental Health

  NPD

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1932855491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-224-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-224-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "JUSTIN",
        "middle_name": "RITCHIE",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-23",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC014288",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmacdonald@spectrapa.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "390 Reed Rd Fl 1",
            "city": "Broomall",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190084008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiu Say Ly
• Sherry Ly, PAC
• Sarah Lynch, MA MFT, LPC
• Shaquay Lynch, COTA
• Colin Maccrory, LPC
• Julie Carol Madonna, M.S.P.T.
• Nicole Maguire
• Main Line Hospitals, Inc.
• Main Line Hospitals, Inc.
• Main Line PA Endoscopy ASC, LP (Main Line Endoscopy Center Broomall)

• Professional Counselor in Broomall, PA
• Providers in Broomall, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.