Provider Demographics
NPI:1003345851
Name:LICHTENBARGER, RAMONA VIOLA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:VIOLA
Last Name:LICHTENBARGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12263 CHOCTAW TRL
Mailing Address - Street 2:
Mailing Address - City:CULVER
Mailing Address - State:IN
Mailing Address - Zip Code:46511-9675
Mailing Address - Country:US
Mailing Address - Phone:574-242-9830
Mailing Address - Fax:
Practice Address - Street 1:12263 CHOCTAW TRL
Practice Address - Street 2:
Practice Address - City:CULVER
Practice Address - State:IN
Practice Address - Zip Code:46511-9675
Practice Address - Country:US
Practice Address - Phone:574-242-9830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005571A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical