| Brenda B. Donald, Lcsw | |
|
133 Executive Dr Ste D Madison MS 39110-8440 | |
| (601) 898-7778 | |
| (601) 607-5019 |
| Full Name | Brenda B. Donald, Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 133 Executive Dr Ste D, Madison, Mississippi |
| Authorized Official Name and Position | Courtney B. Chance (ASSISTANT) |
| Authorized Official Contact | 6015195811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda B. Donald, Lcsw 133 Executive Dr Ste D Madison MS 39110-8440 Ph: (601) 898-7778 | Brenda B. Donald, Lcsw 133 Executive Dr Ste D Madison MS 39110-8440 Ph: (601) 898-7778 |
| NPI Number | 1811408545 |
|---|---|
| Provider Enumeration Date | 10/20/2017 |
| Last Update Date | 10/20/2017 |
| Medicare PECOS PAC ID | 0749665941 |
|---|---|
| Medicare Enrollment ID | O20220923000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811408545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C0902 (Mississippi) | Primary |
| Provider Name | Brenda B Donald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114047677 PECOS PAC ID: 0941685168 Enrollment ID: I20220923000939 |
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