Provider Demographics
NPI:1073679072
Name:LANZETTA, RONDA M (LMHC)
Entity Type:Individual
Prefix:MS
First Name:RONDA
Middle Name:M
Last Name:LANZETTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TRALEE LN
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-4837
Mailing Address - Country:US
Mailing Address - Phone:508-845-4099
Mailing Address - Fax:
Practice Address - Street 1:SMOC BEHAVIORAL HEALTH SERVICES
Practice Address - Street 2:133 EAST MAIN STREET
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752
Practice Address - Country:US
Practice Address - Phone:508-480-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health