Provider Demographics
NPI:1376848416
Name:RONALD R SUMMERHILL, PC
Entity Type:Organization
Organization Name:RONALD R SUMMERHILL, PC
Other - Org Name:SUMMERHILL PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:SUMMERHILL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:480-580-3234
Mailing Address - Street 1:3066 BERNA WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-5640
Mailing Address - Country:US
Mailing Address - Phone:480-580-3234
Mailing Address - Fax:
Practice Address - Street 1:3066 BERNA WAY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-5640
Practice Address - Country:US
Practice Address - Phone:480-580-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1111101Y00000X
AZ3809103G00000X, 103TB0200X, 103TC0700X, 103TF0200X, 103TF0200X, 103TC0700X
AZ4069103TC2200X
IA02846104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty