Provider Demographics
NPI:1093734303
Name:PACE, RONNIE L JR (LPCC LMHC LMFT LPC)
Entity Type:Individual
Prefix:
First Name:RONNIE
Middle Name:L
Last Name:PACE
Suffix:JR
Gender:M
Credentials:LPCC LMHC LMFT LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6114 VALLEY CLFS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-5757
Mailing Address - Country:US
Mailing Address - Phone:210-645-5289
Mailing Address - Fax:866-302-2959
Practice Address - Street 1:6114 VALLEY CLFS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-5757
Practice Address - Country:US
Practice Address - Phone:210-645-5289
Practice Address - Fax:866-302-2959
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8209101YP2500X
LALPC 2001101YP2500X
LALMFT 610106H00000X
TX68943101YP2500X
CO6341101YP2500X
NM144781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist