Provider Demographics
NPI:1174689426
Name:BEGLEY, RONALD G (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:G
Last Name:BEGLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SE MAYNARD RD
Mailing Address - Street 2:STE 255
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-272-5407
Mailing Address - Fax:
Practice Address - Street 1:1150 SE MAYNARD RD
Practice Address - Street 2:STE 255
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-272-5407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6002807Medicaid
VA2877958Medicare ID - Type Unspecified