Provider Demographics
NPI:1245789221
Name:STEIN, RONALD (LPC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:STEIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 N MAIN ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-3652
Mailing Address - Country:US
Mailing Address - Phone:817-230-4100
Mailing Address - Fax:
Practice Address - Street 1:412 N MAIN ST
Practice Address - Street 2:SUITE 209
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-3652
Practice Address - Country:US
Practice Address - Phone:817-230-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-01
Last Update Date:2016-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional