| Dr. Kenneth J. Mcdonald, Psy.d., Llc | |
|
356 East Elkhorn Ave. Estes Park CO 80517 | |
| (415) 264-9504 | |
| Not Available |
| Full Name | Dr. Kenneth J. Mcdonald, Psy.d., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 356 East Elkhorn Ave., Estes Park, Colorado |
| Authorized Official Name and Position | Kenneth Mcdonald (OWNER) |
| Authorized Official Contact | 4152649504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Kenneth J. Mcdonald, Psy.d., Llc 9347 Sugarloaf Rd Boulder CO 80302-9221 Ph: (415) 264-9504 | Dr. Kenneth J. Mcdonald, Psy.d., Llc 356 East Elkhorn Ave. Estes Park CO 80517 Ph: (415) 264-9504 |
| NPI Number | 1861959355 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 02/21/2019 |
| Medicare PECOS PAC ID | 2163763467 |
|---|---|
| Medicare Enrollment ID | O20190416000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861959355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kenneth Joseph Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366910028 PECOS PAC ID: 3072854371 Enrollment ID: I20190715000274 |
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