Mr Ronald Grant Macdonald Jr, LPC, LISAC | |
463 S. Lake Powell Blvd, Page, AZ 86040-0790 | |
(928) 645-5113 | |
(928) 645-3254 |
Full Name | Mr Ronald Grant Macdonald Jr |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 463 S. Lake Powell Blvd, Page, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871558361 | NPI | - | NPPES |
832859 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | LISAC-0989 (Arizona) | Secondary |
101YP2500X | Counselor - Professional | LPC-10208 (Arizona) | Primary |
Entity Name | Community Bridges Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558095315 PECOS PAC ID: 2062699721 Enrollment ID: O20110606000388 |
Mailing Address | Practice Location Address |
---|---|
Mr Ronald Grant Macdonald Jr, LPC, LISAC Po Box 790, Page, AZ 86040-0790 Ph: (928) 645-5113 | Mr Ronald Grant Macdonald Jr, LPC, LISAC 463 S. Lake Powell Blvd, Page, AZ 86040-0790 Ph: (928) 645-5113 |
Matthew Aaron Lasslo, Counselor Medicare: Medicare Enrolled Practice Location: 463 S Lake Powell Blvd, Page, AZ 86040 Phone: 928-645-5113 Fax: 928-645-3254 | |
Jared Lynn Kummer, Counselor Medicare: Medicare Enrolled Practice Location: 463 S. Lake Powell Blvd, Page, AZ 86040 Phone: 928-645-5113 | |
Mr. Norman Ray Stevens, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 337 N. Navajo Drive, Page, AZ 86040 Phone: 928-645-6840 Fax: 928-645-8158 | |
Peggy Fuhrman, MASTERS EDUCATION Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 S. Navajo, Page, AZ 86040 Phone: 928-608-4200 Fax: 928-645-5059 | |
Mr. John Valvo, BA, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 463 S. Lake Powell Blvd, Page, AZ 86040 Phone: 928-645-5113 Fax: 928-645-3254 | |
Irene B Jones, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 434 S Lake Powell Blvd, Page, AZ 86040 Phone: 928-608-4170 Fax: 928-645-9243 | |
Mrs. Beverly Jean Horton, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 463 S. Lake Powell Blvd, Page, AZ 86040 Phone: 928-645-5113 |