Provider Demographics
NPI:1053659193
Name:ROLAND, RONALD PHILLIP II (LLMSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:PHILLIP
Last Name:ROLAND
Suffix:II
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 LESLIE DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-7019
Mailing Address - Country:US
Mailing Address - Phone:810-691-5512
Mailing Address - Fax:
Practice Address - Street 1:1110 ELDON BAKER DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1923
Practice Address - Country:US
Practice Address - Phone:810-742-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010951291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical